Drummond, James; Fary, Camdon; Tran, Phong
Greater trochanteric pain syndrome (GTPS), previously referred as trochanteric bursitis, is a debilitating condition characterised by chronic lateral hip pain. The syndrome is thought to relate to gluteal tendinopathy, with most cases responding to non-operative treatment. A number of open and endoscopic surgical techniques targeting the iliotibial band, trochanteric bursa and gluteal tendons have, however, been described for severe recalcitrant cases. We report the outcomes of one such endoscopic approach here. We retrospectively reviewed 49 patients (57 operations) who had undergone endoscopic longitudinal vertical iliotibial band release and trochanteric bursectomy. Inclusion criteria included diagnosed GTPS with a minimum of six months of non-operative treatment. Exclusion criteria included concomitant intra- or extra-articular hip pathology and previous hip surgery including total hip arthroplasty. Outcomes were assessed using the Visual Analogue Scale, Oxford hip Score and International Hip Outcome Tool (iHOT-33). The series included 42 females and 7 males with a mean age of 65.0 years (26.7-88.6). Mean follow-up time was 20.7 months (5.3-41.2). Eight patients had full thickness gluteal tendon tears, of which 7 were repaired. Adjuvant PRP was injected intraoperatively in 38 of 57 operations (67.2 %). At follow-up, overall mean Visual Analogue Scale values had decreased from 7.8 to 2.8 (p < 0.001), Oxford hip Scores had increased from 20.4 to 37.3 (p < 0.001) and iHOT-33 scores had increased from 23.8 to 70.2 (p < 0.001). Of the 57 operations performed, patients reported feeling very satisfied with the surgical outcome in 28 operations (49.1 %), satisfied in 17 operations (29.8 %) and less than satisfied in 12 operations (21.1 %). While the majority of patients with GTPS will improve with non-operative management, endoscopic iliotibial band release, trochanteric bursectomy and gluteal tendon repair is a safe and effective treatment for severe
Kahane, Guy; Everett, Jim A C; Earp, Brian D; Farias, Miguel; Savulescu, Julian
A growing body of research has focused on so-called 'utilitarian' judgments in moral dilemmas in which participants have to choose whether to sacrifice one person in order to save the lives of a greater number. However, the relation between such 'utilitarian' judgments and genuine utilitarian impartial concern for the greater good remains unclear. Across four studies, we investigated the relationship between 'utilitarian' judgment in such sacrificial dilemmas and a range of traits, attitudes, judgments and behaviors that either reflect or reject an impartial concern for the greater good of all. In Study 1, we found that rates of 'utilitarian' judgment were associated with a broadly immoral outlook concerning clear ethical transgressions in a business context, as well as with sub-clinical psychopathy. In Study 2, we found that 'utilitarian' judgment was associated with greater endorsement of rational egoism, less donation of money to a charity, and less identification with the whole of humanity, a core feature of classical utilitarianism. In Studies 3 and 4, we found no association between 'utilitarian' judgments in sacrificial dilemmas and characteristic utilitarian judgments relating to assistance to distant people in need, self-sacrifice and impartiality, even when the utilitarian justification for these judgments was made explicit and unequivocal. This lack of association remained even when we controlled for the antisocial element in 'utilitarian' judgment. Taken together, these results suggest that there is very little relation between sacrificial judgments in the hypothetical dilemmas that dominate current research, and a genuine utilitarian approach to ethics. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.
Levy, Becca R.; Leifheit-Limson, Erica
Older individuals assimilate, and are targeted by, contradictory positive and negative age stereotypes. It was unknown whether the influence of stereotype valence is stronger when the stereotype content corresponds to the outcome domain. We randomly assigned older individuals to either positive-cognitive, negative-cognitive, positive-physical, or negative-physical subliminal-age-stereotype groups and assessed cognitive and physical outcomes. As predicted, when the age stereotypes corresponded to the outcome domains, their valence had a significantly greater impact on cognitive and physical performance. This suggests that if a match occurs, it is more likely to generate expectations that become self-fulfilling prophecies. PMID:19290757
Hong, Keun-Sik; Lee, Juneyoung; Bae, Hee-Joon; Lee, Ji Sung; Kang, Dong-Wha; Yu, Kyung-Ho; Han, Moon-Ku; Cho, Yong-Jin; Song, Pamela; Park, Jong-Moo; Oh, Mi-Sun; Koo, Jaseong; Lee, Byung-Chul
Cardioembolic (CE) strokes are more disabling and more fatal than non-CE strokes. Multiple prognostic factors have been recognized, but the magnitude of their relative contributions has not been well explored. Using a prospective stroke outcome database, we compared the 3-month outcomes of CE and non-CE strokes. We assessed the relative contribution of each prognostic factor of initial stroke severity, poststroke complications, and baseline characteristics with multivariable analyses and model fitness improvement using -2 log-likelihood and Nagelkerke R2. This study included 1233 patients with acute ischemic stroke: 193 CE strokes and 1040 non-CE strokes. Compared with the non-CE group, CE group had less modified Rankin Scale (mRS) 0-2 outcomes (47.2% versus 68.5%; odds ratio [95% confidence interval], .41 [.30-.56]), less mRS 0-1 outcomes (33.7% versus 53.5%; .44 [.32-.61]), more mRS 5-6 outcomes (32.1% versus 10.9%; 3.88 [2.71-5.56]), and higher mortality (19.2% versus 5.2%; 4.33 [2.76-6.80]) at 3 months. When adjusting either baseline characteristics or poststroke complications, the outcome differences between the 2 groups remained significant. However, adjusting initial National Institute of Health Stroke Scale (NIHSS) score alone abolished all outcome differences except for mortality. For mRS 0-2 outcomes, the decrement of -2 log-likelihood and the Nagelkerke R2 of the model adjusting initial NIHSS score alone approached 70.2% and 76.7% of the fully adjusting model. Greater stroke severity predominates over all other factors for the worse outcome of CE stroke. Primary prevention and more efficient acute therapy for stroke victims should be given top priorities to reduce the burden of CE strokes. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Kahane, Guy; Everett, Jim A.C.; Earp, Brian D.; Farias, Miguel; Savulescu, Julian
A growing body of research has focused on so-called ‘utilitarian’ judgments in moral dilemmas in which participants have to choose whether to sacrifice one person in order to save the lives of a greater number. However, the relation between such ‘utilitarian’ judgments and genuine utilitarian impartial concern for the greater good remains unclear. Across four studies, we investigated the relationship between ‘utilitarian’ judgment in such sacrificial dilemmas and a range of traits, attitudes, judgments and behaviors that either reflect or reject an impartial concern for the greater good of all. In Study 1, we found that rates of ‘utilitarian’ judgment were associated with a broadly immoral outlook concerning clear ethical transgressions in a business context, as well as with sub-clinical psychopathy. In Study 2, we found that ‘utilitarian’ judgment was associated with greater endorsement of rational egoism, less donation of money to a charity, and less identification with the whole of humanity, a core feature of classical utilitarianism. In Studies 3 and 4, we found no association between ‘utilitarian’ judgments in sacrificial dilemmas and characteristic utilitarian judgments relating to assistance to distant people in need, self-sacrifice and impartiality, even when the utilitarian justification for these judgments was made explicit and unequivocal. This lack of association remained even when we controlled for the antisocial element in ‘utilitarian’ judgment. Taken together, these results suggest that there is very little relation between sacrificial judgments in the hypothetical dilemmas that dominate current research, and a genuine utilitarian approach to ethics. PMID:25460392
Habib, Robert H; Dimitrova, Kamellia R; Badour, Sanaa A; Yammine, Maroun B; El-Hage-Sleiman, Abdul-Karim M; Hoffman, Darryl M; Geller, Charles M; Schwann, Thomas A; Tranbaugh, Robert F
Treatment of multivessel coronary artery disease with traditional single-arterial coronary artery bypass graft (SA-CABG) has been associated with superior intermediate-term survival and reintervention compared with percutaneous coronary intervention (PCI) using either bare-metal stents (BMS) or drug-eluting stents (DES). This study sought to investigate longer-term outcomes including the potential added advantage of multiarterial coronary artery bypass graft (MA-CABG). We studied 8,402 single-institution, primary revascularization, multivessel coronary artery disease patients: 2,207 BMS-PCI (age 66.6 ± 11.9 years); 2,381 DES-PCI (age 65.9 ± 11.7 years); 2,289 SA-CABG (age 69.3 ± 9.0 years); and 1,525 MA-CABG (age 58.3 ± 8.7 years). Patients with myocardial infarction within 24 h, shock, or left main stents were excluded. Kaplan-Meier analysis and Cox regression were used to separately compare 9-year all-cause mortality and unplanned reintervention for BMS-PCI and DES-PCI to respective propensity-matched SA-CABG and MA-CABG cohorts. BMS-PCI was associated with worse survival than SA-CABG, especially from 0 to 7 years (p = 0.015) and to a greater extent than MA-CABG was (9-year follow-up: 76.3% vs. 86.9%; p PCI hazard ratios (HR) were as follows: versus SA-CABG, HR: 0.87; and versus MA-CABG, HR: 0.38. DES-PCI showed similar survival to SA-CABG except for a modest 0 to 3 years surgery advantage (HR: 1.06; p = 0.615). Compared with MA-CABG, DES-PCI exhibited worse survival at 5 (86.3% vs. 95.6%) and 9 (82.8% vs. 89.8%) years (HR: 0.45; p PCI for all comparisons (all p PCI or DES-PCI, resulted in substantially enhanced death and reintervention-free survival. Accordingly, MA-CABG represents the optimal therapy for multivessel coronary artery disease and should be enthusiastically adopted by multidisciplinary heart teams as the best evidence-based therapy. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Pornpattananangkul, Narun; Nadig, Ajay; Heidinger, Storm; Walden, Keegan; Nusslock, Robin
Although waiting for a reward reduces or discounts its value, some people have a stronger tendency to wait for larger rewards and forgo smaller-but-immediate rewards. This ability to delay gratification is captured by individual differences in so-called intertemporal choices in which individuals are asked to choose between larger-but-delayed versus smaller-but-immediate rewards. The current study used event-related potentials (ERPs) to examine whether enhancement in two neurocognitive processes, outcome anticipation and outcome evaluation, modulate individual variability in intertemporal responses. After completing a behavioral intertemporal choice task, 34 participants performed an ERP gambling task. From this ERP task, we separately examined individual differences in outcome anticipation (stimulus-preceding negativity; SPN), early outcome valuation (feedback-related negativity; FRN), and late outcome evaluation (P3). We observed that both elevated outcome-anticipation (SPN) and late outcome-evaluation (P3) neural processes predicted a stronger preference toward larger-but-delayed rewards. No relationship was observed between intertemporal responses and early outcome evaluation (FRN), indicating that the relationship between outcome evaluation and intertemporal responses was specific to the late outcome-evaluation processing stream. Moreover, multiple regression analyses indicated that the SPN and P3 independently modulate individual differences in intertemporal responses, suggesting separate mechanisms underlie the relationship between these two neurocognitive processes and intertemporal responses. Accordingly, we identify two potential neurocognitive modulators of individual variability in intertemporal responses. We discuss the mechanisms underlying these modulators in terms of anticipation-related processing (SPN) and a saliency bias toward gain (compared to loss) outcomes (P3).
Pillai, Anilkumar; Medford, Andrew R L
Correct coding is essential for accurate reimbursement for clinical activity. Published data confirm that significant aberrations in coding occur, leading to considerable financial inaccuracies especially in interventional procedures such as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Previous data reported a 15% coding error for EBUS-TBNA in a U.K. service. We hypothesised that greater physician involvement with coders would reduce EBUS-TBNA coding errors and financial disparity. The study was done as a prospective cohort study in the tertiary EBUS-TBNA service in Bristol. 165 consecutive patients between October 2009 and March 2012 underwent EBUS-TBNA for evaluation of unexplained mediastinal adenopathy on computed tomography. The chief coder was prospectively electronically informed of all procedures and cross-checked on a prospective database and by Trust Informatics. Cost and coding analysis was performed using the 2010-2011 tariffs. All 165 procedures (100%) were coded correctly as verified by Trust Informatics. This compares favourably with the 14.4% coding inaccuracy rate for EBUS-TBNA in a previous U.K. prospective cohort study [odds ratio 201.1 (1.1-357.5), p = 0.006]. Projected income loss was GBP 40,000 per year in the previous study, compared to a GBP 492,195 income here with no coding-attributable loss in revenue. Greater physician engagement with coders prevents coding errors and financial losses which can be significant especially in interventional specialties. The intervention can be as cheap, quick and simple as a prospective email to the coding team with cross-checks by Trust Informatics and against a procedural database. We suggest that all specialties should engage more with their coders using such a simple intervention to prevent revenue losses. Copyright © 2013 S. Karger AG, Basel.
Markowitz, Fred E.; Angell, Beth; Greenberg, Jan S.
Drawing on modified labeling theory and the reflected appraisals process and using longitudinal data from 129 mothers and their adult children with schizophrenia, we estimate models of the effects of mothers' stigmatized identity appraisals of their mentally ill children on reflected and self-appraisals, and how appraisals affect outcomes…
Kahane, Guy; Everett, Jim A.C.; Earp, Brian D.; Farias, Miguel; Savulescu, Julian
A growing body of research has focused on so-called ?utilitarian? judgments in moral dilemmas in which participants have to choose whether to sacrifice one person in order to save the lives of a greater number. However, the relation between such ?utilitarian? judgments and genuine utilitarian impartial concern for the greater good remains unclear. Across four studies, we investigated the relationship between ?utilitarian? judgment in such sacrificial dilemmas and a range of traits, attitudes,...
Full Text Available Facial attractiveness represents an important component of an individual’s overall attractiveness as a potential mating partner. Perceptions of facial attractiveness are expected to vary with age-related changes in health, reproductive value, and power. In this study, we investigated perceptions of facial attractiveness, power, and personality in two groups of women of pre- and post-menopausal ages (35-50 years and 51-65 years, respectively and two corresponding groups of men. We tested three hypotheses: 1 that perceived facial attractiveness would be lower for older than for younger men and women; 2 that the age-related reduction in facial attractiveness would be greater for women than for men; and 3 that for men, there would be a larger increase in perceived power at older ages. Eighty facial stimuli were rated by 60 (30 male, 30 female middle-aged women and men using online surveys. Our three main hypotheses were supported by the data. Consistent with sex differences in mating strategies, the greater age-related decline in female facial attractiveness was driven by male respondents, while the greater age-related increase in male perceived power was driven by female respondents. In addition, we found evidence that some personality ratings were correlated with perceived attractiveness and power ratings. The results of this study are consistent with evolutionary theory and with previous research showing that faces can provide important information about characteristics that men and women value in a potential mating partner such as their health, reproductive value, and power or possession of resources.
Zhu, Xiangru; Gu, Ruolei; Wu, Haiyan; Luo, Yuejia
Recent research demonstrated structural overlap between reward and self processing, but the functional relationship that explains how self processing influences reward processing remains unclear. The present study used an experimentally constrained reflection task to investigate whether individuals' outcome evaluations in a gambling task are modulated by task-unrelated self- and other-reflection processes. The self- and other-reflection task contained descriptions of the self or others, and brain event-related potentials (ERPs) were recorded while 16 normal adults performed a gambling task. The ERP analysis focused on the feedback-related negativity (FRN) component. We found that the difference wave of FRN increased in the self-reflection condition compared with the other-reflection condition. The present findings provide direct evidence that self processing can influence reward processing. Copyright © 2015 Elsevier B.V. All rights reserved.
involves debate on the use and sense of evidence thinking in education. This project was looking for evidence based outcome from reflective journal writing. The outcome was understood as acquirement of: 1) physiotherapy competences aiming for aspects of humanistic practice accentuated in the Danish...... rehabilitation area. 2) An ability for reflective thinking as a generic competence in connection to ideas of knowledge society and late modern thinking. PARTICIPANTS: 21 physiotherapy students (13 female, 8 male) participated in their 5th term, during their second clinical course. All students had attended...... sensitive to categories of competence for physiotherapy practice and levels of reflective thinking. Rating was based on consensus between judges. ANALYSIS: Fisher Exact Test was used for nominal scale categories of competence in physiotherapy practice. Mann-Whitney Rank Sum Test was used for ordinal scale...
Kaltenborn, Alexander; Carl, Ulrich Martin; Hinsche, Tanja; Nitsche, Mirko; Hermann, Robert Michael
Low-dose external beam radiotherapy (ED-EBRT) is frequently used in the therapy of refractory greater trochanteric pain syndrome (GTPS). As studies reporting treatment results are scarce, we retrospectively analyzed our own patient collectives. In all, 60 patients (74 hips) received LD-EBRT (6 x 0.5 Gy in 29 hips, 6 x 1 Gy in 45). The endpoint was the patient's reported subjective response to treatment. The influence of different patient and treatment characteristics on treatment outcome was investigated. At the end of LD-EBRT, 69% reported partial remission, 4% complete remission, no change 28%. A total of 3 months later (n = 52 hips), the results were 37, 33, and 30% and 18 months after LD-EBRT (n = 47) 21, 51, and 28%. In univariate analysis ''inclusion of the total femoral head into the PTV'' and ''night pain before LD-EBRT'' were correlated with symptom remission at the end of LD-EBRT, while ''initial increase in pain during LD-EBRT'' was significantly associated with treatment failure. In multivariable modeling ''initial increase in pain'' was identified as a risk factor for treatment failure (p = 0.007; odds ratio [OR] 0.209; 95% confidence interval [CI] 0.048-0.957), while ''night pain'' was an independent factor for remission (p = 0.038; OR 3.484; 95% CI 1.004-12.6). Three months after LD-EBRT ''night pain'' and ''inclusion of the complete femoral neck circumference into the PTV'' were predictive for remission. LD-EBRT represents a useful treatment option for patients suffering from GTPS. Three months after therapy two-thirds of the patients reported a partial or complete symptom remission. Especially patients who suffered from nocturnal pain seemed to benefit. Treatment appeared to be more effective when the entire circumference of the femoral neck was encompassed. (orig.) [de
Price, Matthew; Anderson, Page; Henrich, Christopher C; Rothbaum, Barbara Olasov
A client's expectation that therapy will be beneficial has long been considered an important factor contributing to therapeutic outcomes, but recent empirical work examining this hypothesis has primarily yielded null findings. The present study examined the contribution of expectancies for treatment outcome to actual treatment outcome from the start of therapy through 12-month follow-up in a clinical sample of individuals (n=72) treated for fear of flying with either in vivo exposure or virtual reality exposure therapy. Using a piecewise hierarchical linear model, outcome expectancy predicted treatment gains made during therapy but not during follow-up. Compared to lower levels, higher expectations for treatment outcome yielded stronger rates of symptom reduction from the beginning to the end of treatment on 2 standardized self-report questionnaires on fear of flying. The analytic approach of the current study is one potential reason that findings contrast with prior literature. The advantages of using hierarchical linear modeling to assess interindividual differences in longitudinal data are discussed.
SETIAWAN, DANIEL NUGRAHA
Nugraha Setiawan, Daniel. 2014. Water Exploitation and Its Outcome Caused byCapitalism as Reflected on Gore Verbinski's Rango Movie. Study Program ofEnglish, Universitas Brawijaya.Supervisor: Yusri Fajar, Co-supervisor: Melania Shinta Harendika.Keywords: water exploitation, environment, capitalism, Rango movie. Water exploitation threats ecosystem and causes a great damage to environment. One of the causes of the water exploitation is capitalism. The movie entitled Rango reveals some causes a...
Kaltenborn, Alexander [Federal Armed Forces Hospital Westerstede, Department of Orthopedic and Trauma Surgery, Westerstede (Germany); Hannover Medical School, Core Facility Quality Management and Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover (Germany); Carl, Ulrich Martin; Hinsche, Tanja [Center for Radiotherapy and Radiooncology Bremen and Westerstede, Westerstede (Germany); Nitsche, Mirko [Center for Radiotherapy and Radiooncology Bremen and Westerstede, Westerstede (Germany); University of Schleswig Holstein, Campus Kiel, Department of Radiotherapy, Karl-Lennert Cancer Center, Kiel (Germany); Hermann, Robert Michael [Center for Radiotherapy and Radiooncology Bremen and Westerstede, Westerstede (Germany); Hannover Medical School, Department of Radiotherapy and Special Oncology, Hannover (Germany)
Low-dose external beam radiotherapy (ED-EBRT) is frequently used in the therapy of refractory greater trochanteric pain syndrome (GTPS). As studies reporting treatment results are scarce, we retrospectively analyzed our own patient collectives. In all, 60 patients (74 hips) received LD-EBRT (6 x 0.5 Gy in 29 hips, 6 x 1 Gy in 45). The endpoint was the patient's reported subjective response to treatment. The influence of different patient and treatment characteristics on treatment outcome was investigated. At the end of LD-EBRT, 69% reported partial remission, 4% complete remission, no change 28%. A total of 3 months later (n = 52 hips), the results were 37, 33, and 30% and 18 months after LD-EBRT (n = 47) 21, 51, and 28%. In univariate analysis ''inclusion of the total femoral head into the PTV'' and ''night pain before LD-EBRT'' were correlated with symptom remission at the end of LD-EBRT, while ''initial increase in pain during LD-EBRT'' was significantly associated with treatment failure. In multivariable modeling ''initial increase in pain'' was identified as a risk factor for treatment failure (p = 0.007; odds ratio [OR] 0.209; 95% confidence interval [CI] 0.048-0.957), while ''night pain'' was an independent factor for remission (p = 0.038; OR 3.484; 95% CI 1.004-12.6). Three months after LD-EBRT ''night pain'' and ''inclusion of the complete femoral neck circumference into the PTV'' were predictive for remission. LD-EBRT represents a useful treatment option for patients suffering from GTPS. Three months after therapy two-thirds of the patients reported a partial or complete symptom remission. Especially patients who suffered from nocturnal pain seemed to benefit. Treatment appeared to be more effective when the entire circumference of the femoral neck was encompassed. (orig.) [German] In der Behandlung des
Moein, C. M. Ansari; ten Duis, H. J.; Oey, P. L.; de Kort, G. A. P.; van der Meulen, W.; van der Werken, Chr
In a level 1 university trauma center, an explorative randomized controlled study was performed to compare soft tissue damage and functional outcome after antegrade femoral nailing through a trochanteric fossa (also known as piriform fossa) entry point to a greater trochanter entry point in patients
Moein, Chloe Ansari; ten Duis, Henk-Jan; Oey, Liam; de Kort, Gerard; van der Meulen, Wout; Vermeulen, Karin; van der Werken, Christiaan
Objectives: This study was performed to explore the relationship between entry point-related soft tissue damage in antegrade femoral nailing and the functional outcome in patients with a proximal third femoral shaft fracture. Design: Retrospective clinical trial. Setting: Level I university trauma
Background: The prevalence of obesity-related adverse health outcomes is increasing among older adults. Because it is thought that nutrition plays an important role in successful aging, there has been considerable interest in the association between dietary patterns of older adults and obesity-relat...
The main purpose of this dissertation was to highlight and address seven challenges related to the measurement of youth cognition, understanding the role of cognitive constructs in anxiety and school refusal, and the examination of cognitive mediators of cognitive-behavioural treatment outcomes. The
Full Text Available Ideally, editorials are written one to two months before publication in the Journal. It was my turn to write this one. I had planned to write the first draft the evening after my clinic on Tuesday, September 11. It didn't get done that night or during the next week. Somehow, the topic that I had originally chosen just didn't seem that important anymore as I, along my friends and colleagues, reflected on the changes that the events of that day were likely to have on our lives.
Travers, Cheryl J; Morisano, Dominique; Locke, Edwin A
Goal-setting theory continues to be among the most popular and influential theories of motivation and performance, although there have been limited academic applications relative to applications in other domains, such as organizational psychology. This paper summarizes existing quantitative research and then employs a qualitative approach to exploring academic growth via an in-depth reflective growth goal-setting methodology. The study focuses on 92 UK final-year students enrolled in an elective advanced interpersonal skills and personal development module, with self-reflection and growth goal setting at its core. Qualitative data in the form of regular reflective written diary entries and qualitative questionnaires were collected from students during, on completion of, and 6 months following the personal growth goal-setting programme. About 20% of students' self-set growth goals directly related to academic growth and performance; students reported that these had a strong impact on their achievement both during and following the reflective programme. Growth goals that were indirectly related to achievement (e.g., stress management) appeared to positively impact academic growth and other outcomes (e.g., well-being). A follow-up survey revealed that growth goal setting continued to impact academic growth factors (e.g., self-efficacy, academic performance) beyond the reflective programme itself. Academic growth can result from both academically direct and indirect growth goals, and growth goal setting appears to be aided by the process of simultaneous growth reflection. The implications for promoting academic growth via this unique learning and development approach are discussed. © 2014 The British Psychological Society.
Morel, Thomas; Cano, Stefan J
Our ability to evaluate outcomes which genuinely reflect patients' unmet needs, hopes and concerns is of pivotal importance. However, much current clinical research and practice falls short of this objective by selecting outcome measures which do not capture patient value to the fullest. In this Opinion, we discuss Patient-Centered Outcomes Measures (PCOMs), which have the potential to systematically incorporate patient perspectives to measure those outcomes that matter most to patients. We argue for greater multi-stakeholder collaboration to develop PCOMs, with rare disease patients and families at the center. Beyond advancing the science of patient input, PCOMs are powerful tools to translate care or observed treatment benefit into an 'interpretable' measure of patient benefit, and thereby help demonstrate clinical effectiveness. We propose mixed methods psychometric research as the best route to deliver fit-for-purpose PCOMs in rare diseases, as this methodology brings together qualitative and quantitative research methods in tandem with the explicit aim to efficiently utilise data from small samples. And, whether one opts to develop a brand-new PCOM or to select or adapt an existing outcome measure for use in a rare disease, the anchors remain the same: patients, their daily experience of the rare disease, their preferences, core concepts and values. Ultimately, existing value frameworks, registries, and outcomes-based contracts largely fall short of consistently measuring the full range of outcomes that matter to patients. We argue that greater use of PCOMs in rare diseases would enable a fast track to Patient-Centered Care.
Van den Boom, Gerard; Paas, Fred; Van Merriënboer, Jeroen
Van den Boom, G., Paas, F., & Van Merriënboer, J. J. G. (2007). Effects of elicited reflections combined with tutor or peer feedback on self-regulated learning and learning outcomes. Learning and Instruction, 17, 532-548.
Yu, Jiwoong; Kwon, Young Suk; Kim, Sinae; Han, Christopher Sejong; Farber, Nicholas; Kim, Jongmyung; Byun, Seok Soo; Kim, Wun-Jae; Jeon, Seong Soo; Kim, Isaac Yi
Active surveillance is now the treatment of choice in men with low risk prostate cancer. Although there is no consensus on which patients are eligible for active surveillance, prostate specific antigen above 10 ng/ml is generally excluded. In an attempt to determine the validity of using a prostate specific antigen cutoff of 10 ng/ml to counsel men considering active surveillance we analyzed a multi-institution database to determine the pathological outcome in men with prostate specific antigen greater than 10 ng/ml but histologically favorable risk prostate cancer. We queried a prospectively maintained database of men with histologically favorable risk prostate cancer who underwent radical prostatectomy between 2003 and 2015. The cohort was categorized into 3 groups based on prostate specific antigen level, including low-less than 10 ng/ml, intermediate-10 or greater to less than 20 and high-20 or greater. Associations of prostate specific antigen group with adverse pathological and oncologic outcomes were analyzed. Of 2,125 patients 1,327 were categorized with histologically favorable risk disease. However on multivariate analyses the rates of up staging and upgrading were similar between the intermediate and low prostate specific antigen groups. In contrast compared to the intermediate prostate specific antigen group the high group had higher incidences of up staging (p = 0.02) and upgrading to 4 + 3 or greater disease (p = 0.046). Biochemical recurrence-free survival rates revealed no pairwise intergroup differences except between the low and high groups. Patients with preoperatively elevated prostate specific antigen between 10 and less than 20 ng/ml who otherwise had histologically favorable risk prostate cancer were not at higher risk for adverse pathological outcomes than men with prostate specific antigen less than 10 ng/ml. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Cross, Matthew; Kemp, Simon; Smith, Andrew; Trewartha, Grant; Stokes, Keith
Aim To investigate incidence of concussion, clinical outcomes and subsequent injury risk following concussion. Methods In a two-season (2012/2013, 2013/2014) prospective cohort study, incidence of diagnosed match concussions (injuries/1000 h), median time interval to subsequent injury of any type (survival time) and time spent at each stage of the graduated return to play pathway were determined in 810 professional Rugby Union players (1176 player seasons). Results Match concussion incidence was 8.9/1000 h with over 50% occurring in the tackle. Subsequent incidence of any injury for players who returned to play in the same season following a diagnosed concussion (122/1000 h, 95% CI 106 to 141) was 60% higher (IRR 1.6, 95% CI 1.4 to 1.8) than for those who did not sustain a concussion (76/1000 h, 95% CI 72 to 80). Median time to next injury following return to play was shorter following concussion (53 days, 95% CI 41 to 64) than following non-concussive injuries (114 days, 95% CI 85 to 143). 38% of players reported recurrence of symptoms or failed to match their baseline neurocognitive test during the graduated return to play protocol. Summary and conclusions Players who returned to play in the same season after a diagnosed concussion had a 60% greater risk of time-loss injury than players without concussion. A substantial proportion of players reported recurrence of symptoms or failed to match baseline neurocognitive test scores during graduated return to play. These data pave the way for trials of more conservative and comprehensive graduated return to play protocols, with a greater focus on active rehabilitation. PMID:26626266
Sugimoto, Seiichiro; Yamane, Masaomi; Otani, Shinji; Kurosaki, Takeshi; Okahara, Shuji; Hikasa, Yukiko; Toyooka, Shinichi; Kobayashi, Motomu; Oto, Takahiro
Airway complications (ACs) after living-donor lobar lung transplantation (LDLLT) could have different features from those after cadaveric lung transplantation (CLT). We conducted this study to compare the characteristics of ACs after LDLLT vs. those after CLT and investigate their impact on outcomes. We reviewed, retrospectively, data on 163 recipients of lung transplantation, including 83 recipients of LDLLT and 80 recipients of CLT. The incidence of ACs did not differ between LDLLT and CLT. The initial type of AC after LDLLT was limited to stenosis in all eight patients, whereas that after CLT consisted of stenosis in three patients and necrosis in ten patients (p = 0.0034). ACs after LDLLT necessitated significantly earlier initiation of treatment than those after CLT (p = 0.032). The overall survival rate of LDLLT recipients with an AC was significantly lower than that of those without an AC (p = 0.030), whereas the overall survival rate was comparable between CLT recipients with and those without ACs (p = 0.25). ACs after LDLLT, limited to bronchial stenosis, require significantly earlier treatment and have a greater adverse impact on survival than ACs after CLT.
Full Text Available Background: The KwaZulu-Natal Sandstone Sourveld (KZNSS Research Programme is part of a collaborative, transdisciplinary research partnership between the University of KwaZulu-Natal and the eThekwini Municipality (EM, aimed at bridging the science-policy-practice gap. The research programme focuses on generating knowledge and capacity to support local land-use planning, management and policy development related to biodiversity and climate change issues. Objectives: The objectives were (1 to describe how a continuous reflective evaluation approach helped to better understand the research programme and its outcomes; and (2 to assess research outputs and outcomes, relevance of outcomes to the requirements of EM, and participants’ perceptions of the programme (both the outcomes and the process. Methods: The evaluation took a mixed methods approach, combining various quantitative and qualitative methods such as anonymous individual questionnaires, reflective exercises and group reflections. Results: The KZNSS programme was successful in capacity building and establishing a long-term partnership, but had lower scientific publication output and practice uptake than expected. Participants’ perceptions changed over time, with a decrease in the perceived success of addressing tangible research outcomes, and an increase in the perceived success of collaborative relationships in the partnership. Conclusion: Transdisciplinary partnerships can be a means of integrating research into policy and practice through knowledge exchange. An important lesson in the early stages of this partnership was to pay attention to the process and not only the outputs. The study highlights the importance of continuous participatory reflection and evaluation in such partnerships.
Kosciw, Joseph G; Palmer, Neal A; Kull, Ryan M
For lesbian, gay, bisexual, and transgender (LGBT) youth, coming out (i.e., disclosure of LGBT identity to others) can be a key developmental milestone, one that is associated with better psychological well-being. However, this greater visibility may come with increased risk of peer victimization. Being out, therefore, may reflect resilience and may unfold differently depending on ecological context as some spaces may be more or less supportive of LGBT youth than others. This article explores a model of risk and resilience for outness among LGBT youth, including whether it varies by community context. We tested our hypothesized model with a national dataset of 7,816 LGBT secondary school students using multi-group structural equation modeling. Consistent with our hypotheses, outness was related to higher victimization but also to higher self-esteem and lower depression. Greater victimization was related to negative academic outcomes directly and indirectly via diminished well-being. The increases in victimization associated with outness were larger for rural youth, and benefits to well-being partly compensated for their lower well-being overall. This article suggests that being out reflects resilience in the face of higher risk of victimization, in addition to promoting well-being in other ways. Nonetheless, contextual factors influence how this model operates among LGBT youth.
In September 2005, nearly 3.7 million people evacuated the Texas coastline in advance of Hurricane Rita's landfall, making the event the largest emergency evacuation in US history. The Rita evacuation underscored the importance of planning for domestic mass-evacuation events, as the evacuation itself led to over 100 of the at least 119 deaths attributed to the storm. In the days preceding Rita's landfall, several cascading, interrelated circumstances precipitated such adverse outcomes. This article explores the series of events leading up to the evacuation's poor outcomes, the response following Rita to amend evacuation plans, and how Texas successfully implemented these changes during later storms to achieve better outcomes. (Disaster Med Public Health Preparedness. 2018;12:115-120).
Ramseyer, Fabian; Tschacher, Wolfgang
Objective: The authors quantified nonverbal synchrony--the coordination of patient's and therapist's movement--in a random sample of same-sex psychotherapy dyads. The authors contrasted nonverbal synchrony in these dyads with a control condition and assessed its association with session-level and overall psychotherapy outcome. Method: Using an…
Muhammad, Michael; Wallerstein, Nina; Sussman, Andrew L; Avila, Magdalena; Belone, Lorenda; Duran, Bonnie
The practice of community based participatory research (CBPR) has evolved over the past 20 years with the recognition that health equity is best achieved when academic researchers form collaborative partnerships with communities. This article theorizes the possibility that core principles of CBPR cannot be realistically applied unless unequal power relations are identified and addressed. It provides theoretical and empirical perspectives for understanding power, privilege, researcher identity and academic research team composition, and their effects on partnering processes and health disparity outcomes. The team's processes of conducting seven case studies of diverse partnerships in a national cross-site CBPR study are analyzed; the multi-disciplinary research team's self-reflections on identity and positionality are analyzed, privileging its combined racial, ethnic, and gendered life experiences, and integrating feminist and post-colonial theory into these reflections. Findings from the inquiry are shared, and incorporating academic researcher team identity is recommended as a core component of equalizing power distribution within CBPR.
Bowne, Jocelyn Bonnes; Magnuson, Katherine A.; Schindler, Holly S.; Duncan, Greg J.; Yoshikawa, Hirokazu
This study uses data from a comprehensive database of U.S. early childhood education program evaluations published between 1960 and 2007 to evaluate the relationship between class size, child-teacher ratio, and program effect sizes for cognitive, achievement, and socioemotional outcomes. Both class size and child-teacher ratio showed nonlinear…
Full Text Available Research suggests that journaling will increase reflection and improve program outcomes (Bain, et al, 1999; Duerden, et al, 2012 This study involved a partnership with a non-profit, Global Explorers (GEx, which provides international immersion experiences for youth. Their programs are designed to teach youth participants principles of leadership, environmental awareness, service, and science. This study, which tested whether teaching journaling techniques to youth program facilitators would have a positive impact on participant outcomes, addressed the following hypotheses: 1 Greater training in reflective thinking among participants would be associated with higher outcome scores, and 2 Participants in the intervention group (facilitators trained in journaling pedagogy would show greater increases in reflective thinking than comparison group members. Results based on participant self-assessment were significant in testing the first hypothesis; reflective thinking is positively associated with outcome measures, but the intervention group did not show increases in reflective thinking.
Xie, Chenxi; Sifrim, Daniel; Li, Yuwen; Chen, Minhu; Xiao, Yinglian
Esophageal baseline impedance, which is decreased in gastroesophageal reflux disease (GERD) patients, is related to the severity of acid reflux and the integrity of the esophageal mucosa. The study aims to compare the baseline impedance and the dilated intercellular spaces (DIS) within patients with typical reflux symptoms and to evaluate the correlation of baseline impedance with DIS, esophageal acid exposure, as well as the efficacy of proton pump inhibitor (PPI) treatment. Ninety-two patients and 10 healthy controls were included in the study. Erosive esophagitis (EE) was defined by esophageal mucosal erosion under upper endoscopy. Patients without mucosa erosion were divided into groups with pathologic acid reflux (non-erosive reflux disease [NERD]) or with hypersensitive esophagus. The biopsies of esophageal mucosa were taken 2-4 cm above the gastroesophageal junction Z-line during upper endoscopy for DIS measurement. All the patients received esomeprazole 20 mg twice-daily treatment for 8 weeks. The efficacy of esomeprazole was evaluated among all patients. The intercellular spaces were dilated in both EE and NERD patients ( P baseline impedance was decreased in both EE patients and NERD patients, and negatively correlated to the acid exposure time ( r = -0.527, P baseline impedance ( r = -0.230, P Baseline impedance > 1764 Ω" was an independent predictor for PPI failure (OR, 11.9; 95% CI, 2.4-58.9; P baseline impedance was observed in patients with mucosa erosion or pathological acid reflux. The baseline impedance reflected the mucosal integrity, it was more sensitive to esophageal acid exposure. Patients with high impedance might not benefit from the PPI treatment.
As health care costs increase, evaluating treatment methods in femoral neck fractures to determine the most effective treatment paradigm will become increasingly important. The current study compared two methods of treatment in similar cohorts of displaced femoral neck fractures. One hundred and twenty two patients were randomly assigned to two groups: In Group A, 62 patients were treated with a hemiarthroplasty. In group B, 60 patients were treated with dynamic screw fixation. Patients were evaluated at a minimum 3 year follow-up. Using the Matta functional hip score, 42% of group A and 70% of group B had good to excellent results. This difference was significant (p = 0.004). A significant agreement between physician assessment using the Matta score, and patient perception of outcome using the SF-36 scale was demonstrated (r = 0.64). No statistical difference between groups for revision surgery existed. Both physician based and patient based outcome scores favour retention and internal fixation of the femoral head in this cohort of patients at a short-term follow-up.
Vaisman, Fernanda; Momesso, Denise; Bulzico, Daniel A.; Pessoa, Cencita H. C. N.; da Cruz, Manuel Domingos Gonçalves; Dias, Fernando; Corbo, Rossana; Vaisman, Mario; Tuttle, R. Michael
Background and Objective. An individualized risk-based approach to the treatment of thyroid cancer is being extensively discussed in the recent literature. However, controversies about the ideal surgical approach remain an important issue with regard to the impact on prognosis and follow-up strategies. This study was designed to describe clinical outcomes in a cohort of low and intermediate risk thyroid cancer patients treated with thyroid lobectomy. Methods. Retrospective review of 70 patients who underwent lobectomy. Results. After a median follow-up of 11 years, 5 patients (5/70, 7.1%) recurred and 5 had a completion for benign lesions, while 60 patients (86%) continued to be observed without evidence for disease recurrence. Suspicious ultrasound findings were significantly more common in patients that had structural disease recurrence (100% versus 4.3%, P < 0.001). Furthermore, a rising suppressed Tg value over time was also associated with structural disease recurrence (80% versus 21.5%, P = 0.01). After additional therapy, 99% of the patients had no evidence of disease. Conclusions. Properly selected thyroid cancer patients can be treated with lobectomy with excellent clinical outcomes. PMID:24455413
Full Text Available Background and Objective. An individualized risk-based approach to the treatment of thyroid cancer is being extensively discussed in the recent literature. However, controversies about the ideal surgical approach remain an important issue with regard to the impact on prognosis and follow-up strategies. This study was designed to describe clinical outcomes in a cohort of low and intermediate risk thyroid cancer patients treated with thyroid lobectomy. Methods. Retrospective review of 70 patients who underwent lobectomy. Results. After a median follow-up of 11 years, 5 patients (5/70, 7.1% recurred and 5 had a completion for benign lesions, while 60 patients (86% continued to be observed without evidence for disease recurrence. Suspicious ultrasound findings were significantly more common in patients that had structural disease recurrence (100% versus 4.3%, P<0.001. Furthermore, a rising suppressed Tg value over time was also associated with structural disease recurrence (80% versus 21.5%, P=0.01. After additional therapy, 99% of the patients had no evidence of disease. Conclusions. Properly selected thyroid cancer patients can be treated with lobectomy with excellent clinical outcomes.
Hannon, Charles P; Weber, Alexander E; Gitelis, Matthew; Meyer, Maximillian A; Yanke, Adam B; Cole, Brian J
To compare the osteochondral allograft (OCA) outcomes of bipolar defects with isolated femoral defects and to investigate the optimal treatment of bipolar defects by comparing femoral OCA with tibial debridement to femoral OCA and tibial microfracture. A series of patients with 2-year follow-up from March 2004 to September 2015 after femoral OCA for bipolar chondral defects was identified. Group 1 contained patients with tibial defects treated with debridement and group 2 contained patients with microfractured tibial defects. A third group (group 3) with isolated femoral defects treated with OCA was identified and matched by gender, body mass index (BMI), laterality, and OCA size to groups 1 and 2. Patient-specific, defect-specific, intraoperative, and postoperative data including patient-reported outcomes were collected on all patients. The study groups were compared using analyses of variance, paired sample t tests, and χ-square analyses. Thirty-six patients who had femoral OCA for bipolar lesions were identified with 20 patients in group 1 and 16 patients in group 2. Group 3 had 20 patients. There were no differences between the 3 groups in terms of gender (P = .616), BMI (P = .271), number of previous surgeries (P = .451), femoral or tibial defect size (P = .296), and OCA size (P = .981). Preoperative to postoperative patient-reported clinical outcomes (PROs) revealed statistical and clinically meaningful improvement in all 3 groups, but did not differ between groups. Patient-specific and defect-specific factors did not correlate with PROs. The graft survivorship for group 1 was 85% at 4.5 years, 100% for group 2 at 2.5 years, and 95% for group 3 at 3.8 years. Regardless of tibial treatment, patients with bipolar defects treated with femoral OCA have clinically meaningful improvements in PROs and excellent graft survivorship comparable to isolated femoral OCAs at more than 2 years. Level III, case-control study. Copyright © 2017 Arthroscopy
Taniguchi, Tatsunori; Ohtani, Tomohito; Kioka, Hidetaka; Tsukamoto, Yasumasa; Onishi, Toshinari; Nakamoto, Kei; Katsimichas, Themistoklis; Sengoku, Kaoruko; Chimura, Misato; Hashimoto, Haruko; Yamaguchi, Osamu; Sawa, Yoshiki; Sakata, Yasushi
This study sought to investigate whether elevated liver stiffness (LS) values at discharge reflect residual liver congestion and are associated with worse outcomes in patients with heart failure (HF). Transient elastography is a newly developed, noninvasive method for assessing LS, which can be highly reflective of right-sided filling pressure associated with passive liver congestion in patients with HF. LS values were determined for 171 hospitalized patients with HF before discharge using a Fibroscan device. The median LS value was 5.6 kPa (interquartile range: 4.4 to 8.1; range 2.4 to 39.7) and that of right-sided filling pressure, which was estimated based on LS, was 5.7 mm Hg (interquartile range: 4.1 to 8.2 mm Hg; range 0.1 to 18.9 mm Hg). The patients in the highest LS tertile (>6.9 kPa, corresponding to an estimated right-sided filling pressure of >7.1 mm Hg) had advanced New York Heart Association functional class, high prevalence of jugular venous distention and moderate/severe tricuspid regurgitation, large inferior vena cava (IVC) diameter, low hemoglobin and hematocrit levels, high serum direct bilirubin level, and a similar left ventricular ejection fraction compared with the lower tertiles. During follow-up periods (median: 203 days), 8 (5%) deaths and 33 (19%) hospitalizations for HF were observed. The patients in the highest LS group had a significantly higher mortality rate and HF rehospitalization (hazard ratio: 3.57; 95% confidence interval: 1.93 to 6.83; p direct bilirubin and brain natriuretic peptide levels, LS values were predictive of worse outcomes, even after adjustment for these indices. These data suggest that LS is a useful index for assessing systemic volume status and predicting the severity of HF, and that the presence of liver congestion at discharge is associated with worse outcomes in patients with HF. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Wei, Meifen; Li, Chun-I; Wang, Cixin; Ko, Stacy Y
This study examined a moderated mediation model to see whether self-reflection moderated (a) the association between acculturative stress and ethnocultural empathy and (b) the indirect effects of acculturative stress on 2 positive outcomes (i.e., bicultural competence and making positive sense of adversity) through ethnocultural empathy. A total of 330 Asian American college students from a West coast university participated in an online survey. Results from PROCESS supported hypotheses. First, self-reflection significantly moderated the effects of acculturative stress on ethnocultural empathy. Specifically, the effect of acculturative stress on ethnocultural empathy was significantly positive for those with lower self-reflection. Conversely, this effect was not significant for those with higher self-reflection, but ethnocultural empathy was consistently high across all levels of acculturative stress for those with higher self-reflection. Post hoc exploratory analyses examined the moderated mediation model using each of the 5 domains of acculturative stress as predictors; results supported the moderated mediation hypotheses for 2 domains, discrimination and cultural isolation. Second, self-reflection significantly moderated the indirect effects of acculturative stress on 2 positive outcomes through ethnocultural empathy. Results from conditional indirect effects suggested that the indirect effects of acculturative stress on 2 positive outcomes through ethnocultural empathy were significantly positive for those with lower self-reflection. Conversely, the indirect effects were not significant for those with higher self-reflection, but the 2 positive outcomes stayed high at all levels of acculturative stress. Post hoc analyses found that 5 of 6 components of bicultural competence used as outcome variables supported the moderation mediation hypotheses. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Spendelow, Jason S; Butler, Lisa J
The aim of the current study was to identify outcomes of a self-practice/self-reflection (SP/SR) exercise for trainee clinical psychologists. Thirty-two trainees enrolled in their first year of a UK university doctoral clinical psychology training programme completed an online questionnaire following an eight-week exercise. Findings indicated an endorsement of many previously reported benefits of exercise participation, but also the identification of negative outcomes. Thematic analysis of qualitative data revealed that outcomes could be grouped into two main thematic domains (individual task outcomes and task organization issues) along with several subordinate themes. SP/SR is a useful tool in the development of trainee CBT therapist competences. There has been limited previous recognition of potential negative outcomes from this type of exercise. However, these can provide additional impetus for therapist skill development.
Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montréal: does greater coordination of care with primary care physicians have an impact on health outcomes?
Full Text Available Introduction: Chronic disease management requires substantial services integration. A cardiometabolic risk management program inspired by the Chronic Care Model was implemented in Montréal for patients with diabetes or hypertension. One of this study's objectives was to assess the impact of care coordination between the interdisciplinary teams and physicians on patient participation in the program, lifestyle improvements and disease control. Methods: We obtained data on health outcomes from a register of clinical data, questionnaires completed by patients upon entry into the program and at the 12-month mark, and we drew information on the program's characteristics from the implementation analysis. We conducted multiple regression analyses, controlling for patient sociodemographic and health characteristics to measure the association between interdisciplinary team coordination with primary care physicians and various health outcomes. Results: A total of 1689 patients took part in the study (60.1% participation rate. Approximately 40% of patients withdrew from the program during the first year. At the 12-month follow-up (n = 992, we observed a significant increase in the proportion of patients achieving the various clinical targets. The perception by the interdisciplinary team of greater care coordination with primary care physicians was associated with increased participation in the program and the achievement of better clinical results. Conclusion: Greater coordination of patient services between interdisciplinary teams and primary care physicians translates into benefits for patients.
Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montréal: does greater coordination of care with primary care physicians have an impact on health outcomes?
Provost, Sylvie; Pineault, Raynald; Grimard, Dominique; Pérez, José; Fournier, Michel; Lévesque, Yves; Desforges, Johanne; Tousignant, Pierre; Borgès Da Silva, Roxane
Chronic disease management requires substantial services integration. A cardiometabolic risk management program inspired by the Chronic Care Model was implemented in Montréal for patients with diabetes or hypertension. One of this study's objectives was to assess the impact of care coordination between the interdisciplinary teams and physicians on patient participation in the program, lifestyle improvements and disease control. We obtained data on health outcomes from a register of clinical data, questionnaires completed by patients upon entry into the program and at the 12-month mark, and we drew information on the program's characteristics from the implementation analysis. We conducted multiple regression analyses, controlling for patient sociodemographic and health characteristics, to measure the association between interdisciplinary team coordination with primary care physicians and various health outcomes. A total of 1689 patients took part in the study (60.1% participation rate). Approximately 40% of patients withdrew from the program during the first year. At the 12-month follow-up (n = 992), we observed a significant increase in the proportion of patients achieving the various clinical targets. The perception by the interdisciplinary team of greater care coordination with primary care physicians was associated with increased participation in the program and the achievement of better clinical results. Greater coordination of patient services between interdisciplinary teams and primary care physicians translates into benefits for patients.
Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN) has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services. PMID:22640939
Full Text Available Abstract Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services.
In the past 10 years, workers in the Netherlands increasingly report more decision-making power in their work. This is important for an economy in recession and where workers face greater work demands. It makes work more interesting, creates a healthier work environment, and provides opportunities
Clinical treatment outcomes of tuberculosis treated with the basic regimen recommended by the Brazilian National Ministry of Health using fixed-dose combination tablets in the greater metropolitan area of Goiânia, Brazil.
Ferreira, Anna Carolina Galvão; Silva Júnior, José Laerte Rodrigues da; Conde, Marcus Barreto; Rabahi, Marcelo Fouad
To describe the rates of cure, treatment failure, and treatment abandonment obtained with the basic regimen recommended by the Brazilian National Ministry of Health (rifampin, isoniazid, pyrazinamide, and ethambutol for two months, followed by isoniazid and rifampin for four months) involving the use of fixed-dose combination tablets (self-administered treatment), as well as to describe adverse events and their potential impact on treatment outcomes. This was a descriptive study based on prospective data obtained from the medical records of tuberculosis patients (> 18 years of age) treated with the basic regimen at either of two primary health care facilities in the greater metropolitan area of Goiânia, Brazil. The study sample comprised 40 tuberculosis patients. The rate of cure was 67.5%, the rate of treatment abandonment was 17.5%, and there were no cases of treatment failure. Of the 40 patients in the sample, 19 (47%) reported adverse reactions, which were mild and moderate, respectively, in 87% and 13% of the cases. It was not necessary to alter the regimen or discontinue the treatment in any of the cases evaluated. The rate of cure obtained with the self-administered, fixed-dose combination tablet form of the new basic regimen was similar to the historical rates of cure obtained with the previous regimen. The rate of treatment abandonment in our sample was much higher than that considered appropriate (up to 5%).
Clinical treatment outcomes of tuberculosis treated with the basic regimen recommended by the Brazilian National Ministry of Health using fixed-dose combination tablets in the greater metropolitan area of Goiânia, Brazil *
Ferreira, Anna Carolina Galvão; da Silva, José Laerte Rodrigues; Conde, Marcus Barreto; Rabahi, Marcelo Fouad
OBJECTIVE: To describe the rates of cure, treatment failure, and treatment abandonment obtained with the basic regimen recommended by the Brazilian National Ministry of Health-rifampin, isoniazid, pyrazinamide, and ethambutol for two months, followed by isoniazid and rifampin for four months-involving the use of fixed-dose combination tablets (self-administered treatment), as well as to describe adverse events and their potential impact on treatment outcomes. METHODS: This was a descriptive study based on prospective data obtained from the medical records of tuberculosis patients (≥ 18 years of age) treated with the basic regimen at either of two primary health care facilities in the greater metropolitan area of Goiânia, Brazil. RESULTS: The study sample comprised 40 tuberculosis patients. The rate of cure was 67.5%, the rate of treatment abandonment was 17.5%, and there were no cases of treatment failure. Of the 40 patients in the sample, 19 (47%) reported adverse reactions, which were mild and moderate, respectively, in 87% and 13% of the cases. It was not necessary to alter the regimen or discontinue the treatment in any of the cases evaluated. CONCLUSIONS: The rate of cure obtained with the self-administered, fixed-dose combination tablet form of the new basic regimen was similar to the historical rates of cure obtained with the previous basic regimen. The rate of treatment abandonment in our sample was much higher than that considered appropriate (up to 5%). PMID:23503489
Robinson, Rebecca L; Kroenke, Kurt; Williams, David A; Mease, Philip; Chen, Yi; Faries, Douglas; Peng, Xiaomei; Hann, Danette; Wohlreich, Madelaine; McCarberg, Bill
To describe 12-month treatment patterns and outcomes for patients starting a new medication for fibromyalgia in routine clinical practice. Data from 1,700 patients were collected at baseline and 1, 3, 6, and 12 months. Repeated measures and Poisson regression models controlling for demographic, clinical, and baseline outcomes were used to assess changes in health outcomes (Brief Pain Inventory severity and interference, Sheehan Disability Scale, Fibromyalgia Impact Questionnaire), satisfaction, and economic factors for patients who initiated on pregabalin (214, 12.6%), duloxetine (264, 15.5%), milnacipran (134, 7.9%), or tricyclic antidepressants (66, 3.9%). Sensitivity analyses were run using propensity-matched cohorts. Patients started on 145 unique drugs for fibromyalgia, and over 75% of patients took two or more medications concurrently for fibromyalgia at each time point assessed. Overall, patients showed improvement on the four health outcomes, with few differences across medication cohorts. At baseline, patients reported annual averages of 20.3 visits for outpatient care, 27.7 missed days of work, and 32.6 days of care by an unpaid caregiver. The duloxetine and milnacipran (vs pregabalin or tricyclic antidepressant) cohorts had fewer outpatient visits during the 12-month study. Patients reported satisfaction with overall treatment and their fibromyalgia medication (46.0% and 42.8%, respectively). In this real-world setting, patients with fibromyalgia reported modest improvements, high resource, and medication use, and were satisfied with the care they received. Cohort differences were difficult to discern because of the high rates of drug discontinuation and concomitant medication use over the 12-month study period. Wiley Periodicals, Inc.
Kyte, Derek; Reeve, Bryce B; Efficace, Fabio; Haywood, Kirstie; Mercieca-Bebber, Rebecca; King, Madeleine T; Norquist, Josephine M; Lenderking, William R; Snyder, Claire; Ring, Lena; Velikova, Galina; Calvert, Melanie
In 2014, the European Medicines Agency (EMA) released for comment a draft reflection paper on the use of patient-reported outcome (PRO) measures in oncology studies. A twelve-member International Society for Quality of Life Research (ISOQOL) taskforce was convened to coordinate the ISOQOL response. Twenty-one ISOQOL members provided detailed comments and suggestions on the paper: 81 % from academia and 19 % from industry. Taskforce members consolidated and further refined these comments and shared the recommendations with the wider ISOQOL membership. A final response was submitted to the EMA in November 2014. The impending publication of the EMA reflection paper presents a valuable opportunity for ISOQOL to comment on the current direction of EMA PRO guidance and strategy. The EMA paper, although focused on cancer, could serve as a model for using PROs in other conditions, as it provides a useful update surrounding some of the design issues common to all trial research including PRO endpoints. However, we believe there are a number of additional areas in need of greater consideration. The purpose of this commentary is therefore to highlight the strengths of this timely and potentially useful document, but also to outline areas that may warrant further discussion.
Adrianne R Bischoff
Full Text Available Fetal adversity, evidenced by poor fetal growth for instance, is associated with increased risk for several diseases later in life. Classical cut-offs to characterize small (SGA and large for gestational age (LGA newborns are used to define long term vulnerability. We aimed at exploring the possible dynamism of different birth weight cut-offs in defining vulnerability in developmental outcomes (through the Bayley Scales of Infant and Toddler Development, using the example of a gene vs. fetal adversity interaction considering gene choices based on functional relevance to the studied outcome.36-month-old children from an established prospective birth cohort (Maternal Adversity, Vulnerability, and Neurodevelopment were classified according to birth weight ratio (BWR (SGA ≤0.85, LGA >1.15, exploring a wide range of other cut-offs and genotyped for polymorphisms associated with dopamine signaling (TaqIA-A1 allele, DRD2-141C Ins/Ins, DRD4 7-repeat, DAT1-10- repeat, Met/Met-COMT, composing a score based on the described function, in which hypofunctional variants received lower scores.There were 251 children (123 girls and 128 boys. Using the classic cut-offs (0.85 and 1.15, there were no statistically significant interactions between the neonatal groups and the dopamine genetic score. However, when changing the cut-offs, it is possible to see ranges of BWR that could be associated with vulnerability to poorer development according to the variation in the dopamine function.The classic birth weight cut-offs to define SGA and LGA newborns should be seen with caution, as depending on the outcome in question, the protocols for long-term follow up could be either too inclusive-therefore most costly, or unable to screen true vulnerabilities-and therefore ineffective to establish early interventions and primary prevention.
Trevorrow, L.E.; Schubert, J.P.
Greater-confinement disposal (GCD) is a general term for low-level waste (LLW) disposal technologies that employ natural and/or engineered barriers and provide a degree of confinement greater than that of shallow-land burial (SLB) but possibly less than that of a geologic repository. Thus GCD is associated with lower risk/hazard ratios than SLB. Although any number of disposal technologies might satisfy the definition of GCD, eight have been selected for consideration in this discussion. These technologies include: (1) earth-covered tumuli, (2) concrete structures, both above and below grade, (3) deep trenches, (4) augered shafts, (5) rock cavities, (6) abandoned mines, (7) high-integrity containers, and (8) hydrofracture. Each of these technologies employ several operations that are mature,however, some are at more advanced stages of development and demonstration than others. Each is defined and further described by information on design, advantages and disadvantages, special equipment requirements, and characteristic operations such as construction, waste emplacement, and closure
Changes in our political infrastructure, the continuing frailties of our economy, and a stark growth in population, have greatly impacted upon the perceived stability of the NHS. Healthcare teams have had to adapt to these changes, and so too have the technologies upon which they rely to deliver first-class patient care. Here Sarah Hunt, marketing co-ordinator at Aid Call, assesses how the changing healthcare environment has affected one of its fundamental technologies - the nurse call system, argues the case for wireless such systems in terms of what the company claims is greater adaptability to changing needs, and considers the ever-wider range of features and functions available from today's nurse call equipment, particularly via connectivity with both mobile devices, and ancillaries ranging from enuresis sensors to staff attack alert 'badges'.
Arenas, Ismael Enrique
Geologically speaking, Colombia is a very attractive country for the world oil community. According to this philosophy new and important steps are being taken to reinforce the oil sector: Expansion of the exploratory frontier by including a larger number of sedimentary areas, and the adoption of innovative contracting instruments. Colombia has to offer, Greater economic incentives for the exploration of new areas to expand the exploratory frontier, stimulation of exploration in areas with prospectivity for small fields. Companies may offer Ecopetrol a participation in production over and above royalties, without it's participating in the investments and costs of these fields, more favorable conditions for natural gas seeking projects, in comparison with those governing the terms for oil
Vachon, Brigitte; Désorcy, Bruno; Gaboury, Isabelle; Camirand, Michel; Rodrigue, Jean; Quesnel, Louise; Guimond, Claude; Labelle, Martin; Huynh, Ai-Thuy; Grimshaw, Jeremy
Improving primary care for chronic disease management requires a coherent, integrated approach to quality improvement. Evidence in the continuing professional development (CPD) field suggests the importance of using strategies such as feedback delivery, reflective practice and action planning to facilitate recognition of gaps and service improvement needs. Our study explored the outcomes of a CPD intervention, named the COMPAS Project, which consists of a three-hour workshop composed of three main activities: feedback, critical reflection and action planning. The feedback intervention is delivered face-to-face and presents performance indicators extracted from clinical-administrative databases. This aim of this study was to assess the short term outcomes of this intervention to engage primary care professional in continuous quality improvement (QI). In order to develop an understanding of our intervention and of its short term outcomes, a program evaluation approach was used. Ten COMPAS workshops on diabetes management were directly observed and qualitative data was collected to assess the intervention short term outcomes. Data from both sources were combined to describe the characteristics of action plans developed by professionals. Two independent coders analysed the content of these plans to assess if they promoted engagement in QI and interprofessional collaboration. During the ten workshops held, 26 interprofessional work teams were formed. Twenty-two of them developed a QI project they could implement themselves and that targeted aspects of their own practice they perceived in need of change. Most frequently prioritized strategies for change were improvement of systematic clientele follow-up, medication compliance, care pathway and support to improve adoption of healthier life habits. Twenty-one out of 22 action plans were found to target some level of improvement of interprofessional collaboration in primary care. Our study results demonstrate that the
Lystbæk, Christian Tang
associated with reflection and an exploration of alternative conceptions that view reflection within the context of settings which have a more group- and team-based orientation. Drawing on an action research project on health care supervision, the paper questions whether we should reject earlier views...... of reflection, rehabilitate them in order to capture broader connotations or move to new ways of regarding reflection that are more in keeping with not only reflective but also emotive, normative and formative views on supervision. The paper presents a critical perspective on supervision that challenge...... the current reflective paradigm I supervision and relate this to emotive, normative and formative views supervision. The paper is relevant for Nordic educational research into the supervision and guidance...
Full Text Available The antioxidant enzyme heme oxygenase-1 (HO-1 is implicated in the pathogenesis of tuberculosis (TB and has been proposed as a biomarker of active disease. Nevertheless, the mechanisms by which Mycobacterium tuberculosis (Mtb induces HO-1 as well as how its expression is affected by HIV-1 coinfection and successful antitubercular therapy (ATT are poorly understood. We found that HO-1 expression is markedly increased in rabbits, mice, and non-human primates during experimental Mtb infection and gradually decreased during ATT. In addition, we examined circulating concentrations of HO-1 in a cohort of 130 HIV-1 coinfected and uninfected pulmonary TB patients undergoing ATT to investigate changes in expression of this biomarker in relation to HIV-1 status, radiological disease severity, and treatment outcome. We found that plasma levels of HO-1 were elevated in untreated HIV-1 coinfected TB patients and correlated positively with HIV-1 viral load and negatively with CD4+ T cell count. In both HIV-1 coinfected and Mtb monoinfected patients, HO-1 levels were substantially reduced during successful TB treatment but not in those who experienced treatment failure or subsequently relapsed. To further delineate the molecular mechanisms involved in induction of HO-1 by Mtb, we performed a series of in vitro experiments using mouse and human macrophages. We found that Mtb-induced HO-1 expression requires NADPH oxidase-dependent reactive oxygen species production induced by the early-secreted antigen ESAT-6, which in turn triggers nuclear translocation of the transcription factor NRF-2. These observations provide further insight into the utility of HO-1 as a biomarker of both disease and successful therapy in TB monoinfected and HIV-TB coinfected patients and reveal a previously undocumented pathway linking expression of the enzyme with oxidative stress.
Azimi, Parisa; Benzel, Edward C
The Low-Back Outcome Scale (LBOS) of Greenough and Fraser and the Oswestry disability index (ODI) were compared to the patient satisfaction index (PSI) in lumbar disc herniation (LDH) surgery. A total of 134 patients who underwent discectomy were followed through assessment of pre- and post-surgical satisfaction by the PSI, the LBOS, and the ODI. The LBOS were rated as satisfied if the outcomes were excellent or good and as dissatisfied if fair and poor. Considering the ODI, clinically satisfied was defined as a 13-point improvement from the baseline ODI scores. Phi (Φ) correlation analysis was used to study the correlation among the PSI, the LBOS and the ODI scores as proxy for patients' satisfaction. Mean age of patients was 48.9 years. Significant improvement from the pre- to post-operative ODI scores was observed. Post-surgical satisfaction based on the PSI, the ODI, and the LBOS were 70.9%, 76.8%, and 81.3%, respectively. Regarding patient satisfaction, there were weak associations between LBOS vs. PSI and ODI vs. PSI (Φ=-0.054, P=0.533) and (Φ=-0.129, P=0.136), respectively. Our study showed that the ODI and the LBOS were not reflective of patients' satisfaction after discectomy.
Faster eating rates are associated with higher energy intakes during an ad libitum meal, higher BMI and greater adiposity among 4·5-year-old children: results from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) cohort.
Fogel, Anna; Goh, Ai Ting; Fries, Lisa R; Sadananthan, Suresh A; Velan, S Sendhil; Michael, Navin; Tint, Mya-Thway; Fortier, Marielle V; Chan, Mei Jun; Toh, Jia Ying; Chong, Yap-Seng; Tan, Kok Hian; Yap, Fabian; Shek, Lynette P; Meaney, Michael J; Broekman, Birit F P; Lee, Yung Seng; Godfrey, Keith M; Chong, Mary F F; Forde, Ciarán G
Faster eating rates are associated with increased energy intake, but little is known about the relationship between children's eating rate, food intake and adiposity. We examined whether children who eat faster consume more energy and whether this is associated with higher weight status and adiposity. We hypothesised that eating rate mediates the relationship between child weight and ad libitum energy intake. Children (n 386) from the Growing Up in Singapore Towards Healthy Outcomes cohort participated in a video-recorded ad libitum lunch at 4·5 years to measure acute energy intake. Videos were coded for three eating-behaviours (bites, chews and swallows) to derive a measure of eating rate (g/min). BMI and anthropometric indices of adiposity were measured. A subset of children underwent MRI scanning (n 153) to measure abdominal subcutaneous and visceral adiposity. Children above/below the median eating rate were categorised as slower and faster eaters, and compared across body composition measures. There was a strong positive relationship between eating rate and energy intake (r 0·61, P<0·001) and a positive linear relationship between eating rate and children's BMI status. Faster eaters consumed 75 % more energy content than slower eating children (Δ548 kJ (Δ131 kcal); 95 % CI 107·6, 154·4, P<0·001), and had higher whole-body (P<0·05) and subcutaneous abdominal adiposity (Δ118·3 cc; 95 % CI 24·0, 212·7, P=0·014). Mediation analysis showed that eating rate mediates the link between child weight and energy intake during a meal (b 13·59; 95 % CI 7·48, 21·83). Children who ate faster had higher energy intake, and this was associated with increased BMI z-score and adiposity.
Peltier, James W.; Hay, Amanda; Drago, William
The importance of reflection to marketing educators is increasingly recognized. However, there is a lack of empirical research that considers reflection within the context of both the marketing and general business education literature. This article describes the use of an instrument that can be used to measure four identified levels of a…
Reiter, Michael; O'Brien, Seth D; Bui-Mansfield, Liem T; Alderete, Joseph
Proximal femoral fractures are frequently encountered in the emergency department (ED). Prompt diagnosis is paramount as delay will exacerbate the already poor outcomes associated with these injuries. In cases where radiography is negative but clinical suspicion remains high, magnetic resonance imaging (MRI) is the study of choice as it has the capability to depict fractures which are occult on other imaging modalities. Awareness of a particular subset of proximal femoral fractures, namely greater trochanteric fractures, is vital for both radiologists and clinicians since it has been well documented that they invariably have an intertrochanteric component which may require surgical management. The detection of intertrochanteric or cervical extension of greater trochanteric fractures has been described utilizing MRI but is underestimated with both computed tomography (CT) and bone scan. Therefore, if MRI is unavailable or contraindicated, the diagnosis of an isolated greater trochanteric fracture should be met with caution. The importance of avoiding this potential pitfall is demonstrated in the following case of an elderly woman with hip pain and CT demonstrating an isolated greater trochanteric fracture who subsequently returned to the ED with a displaced intertrochanteric fracture.
Lentine, Anthony L.; Nielson, Gregory N.; Cruz-Campa, Jose Luis; Okandan, Murat; Goeke, Ronald S.
A photovoltaic module includes colorized reflective photovoltaic cells that act as pixels. The colorized reflective photovoltaic cells are arranged so that reflections from the photovoltaic cells or pixels visually combine into an image on the photovoltaic module. The colorized photovoltaic cell or pixel is composed of a set of 100 to 256 base color sub-pixel reflective segments or sub-pixels. The color of each pixel is determined by the combination of base color sub-pixels forming the pixel. As a result, each pixel can have a wide variety of colors using a set of base colors, which are created, from sub-pixel reflective segments having standard film thicknesses.
Brun, Ole-Christian L; Maansson, Lukas
We studied the incidence of greater trochanteric fractures at our department following THR. In all we examined 911 patients retrospectively and found the occurance of a greater trochanteric fracture to be 3%. Patients with fractures had significantly poorer outcome on Oxford Hip score, Pain VAS, Satisfaction VAS and EQ-5D compared to THR without fractures. Greater trochanteric fracture following THR is one of the most common complications following THR. It has previously been thought to have little impact on the overall outcome following THR, but our study suggests otherwise.
Home; Journals; Resonance – Journal of Science Education. Personal Reflections. Articles in Resonance – Journal of Science Education. Volume 6 Issue 3 March 2001 pp 90-93 Personal Reflections. Why did I opt for Career in Science? Jayant V Narlikar · More Details Fulltext PDF. Volume 9 Issue 8 August 2004 pp 89-89 ...
In 2005, PISA organised proactive meetings of reflection groups on involvement in decision making, expert culture and ethical aspects of radiation protection.All reflection group meetings address particular targeted audiences while the output publication in book form is put forward
Boura, Christina; Canteaut, Anne; Knudsen, Lars Ramkilde
study the necessary properties for this coupling permutation. Special care has to be taken of some related-key distinguishers since, in the context of reflection ciphers, they may provide attacks in the single-key setting.We then derive some criteria for constructing secure reflection ciphers...
Hartung, Benno; Hellen, Florence; Borchard, Nora; Huckenbeck, Wolfgang
Autoerotic fatalities in the Greater Dusseldorf area correspond to the relevant medicolegal literature. Our results included exclusively young to middle-aged, usually single men who were found dead in their city apartments. Clothing and devices used showed a great variety. Women's or fetish clothing and complex shackling or hanging devices were disproportionately frequent. In most cases, death occurred due to hanging or ligature strangulation. There was no increased incidence of underlying psychiatric disorders. In most of the deceased no or at least no remarkable alcohol intoxication was found. Occasionally, it may be difficult to reliably differentiate autoerotic accidents, accidents occurring in connection with practices of bondage & discipline, dominance & submission (BDSM) from natural death, suicide or homicide.
Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.
A report that provides guidance for planning for greater-confinement disposal (GCD) of low-level radioactive waste is being prepared. The report addresses procedures for selecting a GCD technology and provides information for implementing these procedures. The focus is on GCD; planning aspects common to GCD and shallow-land burial are covered by reference. Planning procedure topics covered include regulatory requirements, waste characterization, benefit-cost-risk assessment and pathway analysis methodologies, determination of need, waste-acceptance criteria, performance objectives, and comparative assessment of attributes that support these objectives. The major technologies covered include augered shafts, deep trenches, engineered structures, hydrofracture, improved waste forms, and high-integrity containers. Descriptive information is provided, and attributes that are relevant for risk assessment and operational requirements are given. 10 refs., 3 figs., 2 tabs
Alcock, Gordon Lindsay
´ These are all based on Blooms taxonomy and levels of competence and form a major part of individual student and group learning portfolios. Key Words :Project-Based learning, Reflective Portfolios, Self assessment, Defining learning gains, Developing learning strategies , Reflections on and for learning....... It contrasts the students’ self-assessment in a range of ‘product’ skills such as Revit, Structural Design, Mathematics of construction, Technical Installations; as well as ‘process’ competencies such as ‘Working in a team’, Sharing knowledge, Maintaining a portfolio and Reflecting ON learning and FOR learning......This paper documents 1st semester student reflections on “learning to learn” in a team-based PBL environment with quantitative and qualitative student reflective feedback on the learning gains of 60 Architectural Technology and Construction Management students at VIA University College, Denmark...
Carrusca, K. [Greater Vancouver Regional District, Burnaby, BC (Canada); Richter, R. [Montenay Inc., Vancouver, BC (Canada)]|[Veolia Environmental Services, Vancouver, BC (Canada)
An outline of the Greater Vancouver Regional District (GVRD) waste-to-energy program was presented. The GVRD has an annual budget for solid waste management of $90 million. Energy recovery revenues from solid waste currently exceed $10 million. Over 1,660,00 tonnes of GVRD waste is recycled, and another 280,000 tonnes is converted from waste to energy. The GVRD waste-to-energy facility combines state-of-the-art combustion and air pollution control, and has processed over 5 million tonnes of municipal solid waste since it opened in 1988. Its central location minimizes haul distance, and it was originally sited to utilize steam through sales to a recycle paper mill. The facility has won several awards, including the Solid Waste Association of North America award for best facility in 1990. The facility focuses on continual improvement, and has installed a carbon injection system; an ammonia injection system; a flyash stabilization system; and heat capacity upgrades in addition to conducting continuous waste composition studies. Continuous air emissions monitoring is also conducted at the plant, which produces a very small percentage of the total air emissions in metropolitan Vancouver. The GVRD is now seeking options for the management of a further 500,000 tonnes per year of solid waste, and has received 23 submissions from a range of waste energy technologies which are now being evaluated. It was concluded that waste-to-energy plants can be located in densely populated metropolitan areas and provide a local disposal solution as well as a source of renewable energy. Other GVRD waste reduction policies were also reviewed. refs., tabs., figs.
Tonni, Ingrid; Mora, Luca; Oliver, Richard G
The aim of this study was to analyze the effects of a portfolio learning strategy designed to develop students' reflection abilities in a postgraduate orthodontic program in the UK. Nine first-year postgraduate orthodontic students and seven mentors participated in the one-year program, which included a reflective portfolio, mentorship, and discussion. After the program, the students' and mentors' perceptions were collected using focus groups and individual interviews, respectively. The data were analyzed using thematic analysis. Four categories emerged. The first, reflection, was considered a skill to learn, and time was needed for students to fully understand its meaning and achieve its outcomes. The second theme, characteristics of reflection, was descriptive at the beginning and more critical at the end of the experience. The third theme, outcomes of reflection, involved students' improved problem-solving and action-planning abilities and increased self-awareness, motivation, confidence, and communication skills. In the fourth theme, stimulation of reflection, students did not agree with mentors regarding the importance of reflective writing, but they recognized the value of the portfolio's reflective log in facilitating the reflective process. There was greater agreement between students and mentors regarding discussions with mentors and among peers as tools to achieve higher levels of reflection. Overall, these students and mentors considered the strategy an effective tool for improving students' reflection.
Smith, J. A.; Cooper, K.; Randolph, M.
A classical description of the one dimensional radiative transfer treatment of vegetation canopies was completed and the results were tested against measured prairie (blue grama) and agricultural canopies (soybean). Phase functions are calculated in terms of directly measurable biophysical characteristics of the canopy medium. While the phase functions tend to exhibit backscattering anisotropy, their exact behavior is somewhat more complex and wavelength dependent. A Monte Carlo model was developed that treats soil surfaces with large periodic variations in three dimensions. A photon-ray tracing technology is used. Currently, the rough soil surface is described by analytic functions and appropriate geometric calculations performed. A bidirectional reflectance distribution function is calculated and, hence, available for other atmospheric or canopy reflectance models as a lower boundary condition. This technique is used together with an adding model to calculate several cases where Lambertian leaves possessing anisotropic leaf angle distributions yield non-Lambertian reflectance; similar behavior is exhibited for simulated soil surfaces.
This is the first book dedicated exclusively to all-reflective imaging systems. It is a teaching tool as well as a practical design tool for anyone who specializes in optics, particularly for those interested in telescopes, infrared, and grazing-incidence systems. The first part of the book describes a unified geometric optical theory of all-reflective imaging systems (from near-normal to grazing incidence) developed from basic principles. The second part discusses correction methods and a multitude of closed-form solutions of well-corrected systems, supplemented with many conventional and unc
van der Meer, Lisette; de Vos, Annerieke E; Stiekema, Annemarie P M; Pijnenborg, Gerdina H M; van Tol, Marie-José; Nolen, Willem A; David, Anthony S; Aleman, André
Impaired insight is a common feature in psychosis and an important predictor of variables such as functional outcome, prognosis, and treatment adherence. A cognitive process that may underlie insight in psychosis is self-reflection, or the conscious evaluation of one's traits and characteristics. The current study aims to investigate the neural correlates of self-reflective processing and its relationship with insight in schizophrenia. Forty-seven schizophrenia patients and 21 healthy controls performed a self-reflection task in a functional magnetic resonance imaging (fMRI) scanner. The tasks comprised a self-reflection, close other-reflection, and a semantic (baseline) condition. Insight scores were obtained with the Schedule of Assessment of Insight Expanded. In addition, cognitive insight scores were obtained (Beck Cognitive Insight Scale [BCIS]). Schizophrenia patients demonstrated less activation in the posterior cingulate cortex in the self- and other-reflection conditions and less activation in the precuneus in the other-reflection condition compared with healthy controls. Better insight was associated with greater response in the inferior frontal gyrus, anterior insula, and inferior parietal lobule during self-reflection. In addition, better cognitive insight was associated with higher activation in ventromedial prefrontal cortex during self-reflection. In the current study, evidence for a relationship between self-reflection and insight in patients with schizophrenia was found in brain areas related to self-reflection, self/other distinction and source attribution. The findings support the rationale for a treatment that is currently under evaluation, which attempts to increase insight by enhancing self-reflection.
de Vos, Annerieke E.
Background: Impaired insight is a common feature in psychosis and an important predictor of variables such as functional outcome, prognosis, and treatment adherence. A cognitive process that may underlie insight in psychosis is self-reflection, or the conscious evaluation of one’s traits and characteristics. The current study aims to investigate the neural correlates of self-reflective processing and its relationship with insight in schizophrenia. Methods: Forty-seven schizophrenia patients and 21 healthy controls performed a self-reflection task in a functional magnetic resonance imaging (fMRI) scanner. The tasks comprised a self-reflection, close other-reflection, and a semantic (baseline) condition. Insight scores were obtained with the Schedule of Assessment of Insight Expanded. In addition, cognitive insight scores were obtained (Beck Cognitive Insight Scale [BCIS]). Results: Schizophrenia patients demonstrated less activation in the posterior cingulate cortex in the self- and other-reflection conditions and less activation in the precuneus in the other-reflection condition compared with healthy controls. Better insight was associated with greater response in the inferior frontal gyrus, anterior insula, and inferior parietal lobule during self-reflection. In addition, better cognitive insight was associated with higher activation in ventromedial prefrontal cortex during self-reflection. Conclusion: In the current study, evidence for a relationship between self-reflection and insight in patients with schizophrenia was found in brain areas related to self-reflection, self/other distinction and source attribution. The findings support the rationale for a treatment that is currently under evaluation, which attempts to increase insight by enhancing self-reflection. PMID:23104865
Full Text Available Cryptococcosis occurs most frequently in immunocompromised individuals. This has led to the prevailing view that this disease is the result of weak immune responses that cannot control the fungus. However, increasingly, clinical and experimental studies have revealed that the host immune response can contribute to cryptococcal pathogenesis, including the recent study of L. M. Neal et al. (mBio 8:e01415-17, 2017, https://doi.org/10.1128/mBio.01415-17 that reports that CD4+ T cells mediate tissue damage in experimental murine cryptococcosis. This finding has fundamental implications for our understanding of the pathogenesis of cryptococcal disease; it helps explain why immunotherapy has been largely unsuccessful in treatment and provides insight into the paradoxical observation that HIV-associated cryptococcosis may have a better prognosis than cryptococcosis in those with no known immune impairment. The demonstration that host-mediated damage can drive cryptococcal disease provides proof of concept that the parabola put forth in the damage-response framework has the flexibility to depict complex and changing outcomes of host-microbe interaction.
Berg, Thomas; Neuhaus, Ruth; Klein, Reinhild; Leder, Korinna; Lobeck, Hartmut; Bechstein, Wolf-Otto; Müller, Andrea R; Wiedenmann, Bertram; Hopf, Uwe; Berg, Peter A; Neuhaus, Peter
Sound information is lacking about the clinical presentation of cryptogenic cirrhosis and its outcome after orthotopic liver transplantation (OLT). Among 856 patients who have been transplanted at our center, 40 patients had no evidence of any known etiologies and were therefore defined as suffering from cryptogenic cirrhosis. Their median follow-up period before OLT was 78 months (range, 1-264), and after OLT 97 months (range, 1-132). Laboratory and histological data were evaluated according to features being compatible either with a toxic, hepatitic, or cholestatic condition. The clinical and histological findings differed specifically between these three groups. The toxic-like group (GGT 4-18 x upper limit of normal [ULN]) expressed significantly higher IgA levels, had histologically more often fatty liver changes, and risk factors for non-alcoholic steatohepatitis predominated (56% compared with 3% in the other groups, P=0.01). The hepatitic-like group (ALT 2-18 x ULN) showed histologically features of chronic hepatitis or hepatitic cirrhosis, and only among these patients a median International Autoimmune Hepatitis (IAH) score of 13 was found suggesting autoimmune hepatitis (AiH). In the cholestatic group (AP 2-8 x ULN) histology was compatible with a non-toxic inflammatory process but IAH score excluded AiH in all. After OLT, actuarial graft and patients survival was 90% at 5 years. Mild or moderate graft hepatitis occurred in 9 patients (23%) and was significantly associated with a pre-OLT IAH score >or= 10 (P =0.008). This study provides arguments that cryptogenic cirrhosis is a heterogeneous disease in which autoimmune mechanisms might be predominately involved and being responsible for recurrence of chronic liver disease observed in some instances after OLT.
Full Text Available The purpose of this paper is to highlight some difficulties of Neil Sinhababu’s Humean theory of agency, which depend on his radically reductivist approach, rather than to his Humean sympathies. The argument is that Sinhababu’s theory builds upon a critique of reflective agency which is based on equivocation and misunderstandings of the Kantian approach. Ultimately, the objection is that his reductivist view is unequipped to address the rclassical problems of rational deliberation and agential authority.
McCabe, Louise; Greasley-Adams, Corinne; Goodson, Katy
This paper presents the findings from an evaluation of a creative musical project led by Scottish Opera. The project included people with dementia and their carers in the development, writing, design and performance of a musical production about their experiences of love. The project involved professional singers, artists and choreographers from the opera company. Activities involved practice sessions and performances. People with dementia and their carers reflected on positive outcomes from the project including improved confidence; being part of a group; improved physical strength and people seeing them in a new way. Within the evaluation framework they also reported on how the project had been run and gave ideas for future development. Key elements in the success of this project were the involvement of professionals, the kudos of working with a national organisation and the performances that, while daunting, provided unique and rewarding experiences. © The Author(s) 2013.
Sørensen, Camilla T. N.; Andersen, Lars Erslev; Jiang, Yang
This collection of short papers is an outcome of an international conference entitled China and the Challenges in Greater Middle East, organized by the Danish Institute for International Studies and Copenhagen University on 10 November 2015. The conference sought answers to the following questions...
produces: that the self is accessible and transcendable, that reflexivity is universal across space and time, and that the self can act as its own remedial change agent or ‘inner consultant.’ I argue that because reflexivity is understood in many different ways, attention to definition is crucial, both...... on the concepts of selfhood that prevail and how notions of difference are constructed. First, I discuss how the dominant usages of reflexivity in intercultural education reflect and reproduce a Cartesian view of the self that shapes how ICC is conceptualized and taught. I discuss three assumptions that this view...
A numberof Chris Freeman's colleagues were asked to reflect on what they thought describes his life and work in a few words. Some of the colleagues replied including former SPRU students that were taught or supervised by Chris Freeman. Their views on what they thought were Chris Freeman's defining...... life is not free from fluctuations, cycles, disruptions, crises and destructions both human and ecological. Innovation research ought to position itself to address environmental, financial and economic crises. The third is innovation research for development by addressing not only poverty erdaication...
Ahrenkiel Jørgensen, Andriette
In Breve fra min Have (Letters from my Garden), the Swedish landscape architect, Sven-Ingvar Andersson, produces dialogues about his garden to a wide circle of friends, colleagues, deceased and still living acquaintances such as Karen Blixen, Gertrude Stein, C. Th. Sørensen, Albrecht Dürer, Peter...... Høeg etetera. The dialogues work as a tool of reflection in terms of providing opportunity to examine his own beliefs, to explore the possible reasons for engaging in a particular activity. On the basis of Sven-Ingvar Andersson’s book a teaching program at the Aarhus School of Architecture provides...
The aluminized polymer film used in spacecraft as a radiation barrier to protect both astronauts and delicate instruments has led to a number of spinoff applications. Among them are aluminized shipping bags, food cart covers and medical bags. Radiant Technologies purchases component materials and assembles a barrier made of layers of aluminized foil. The packaging reflects outside heat away from the product inside the container. The company is developing new aluminized lines, express mailers, large shipping bags, gel packs and insulated panels for the building industry.
Full Text Available The specular neutron reflectivity is a technique enabling the measurement of neutron scattering length density profile perpendicular to the plane of a surface or an interface, and thereby the profile of chemical composition. The characteristic sizes that are probed range from around 5 Å up 5000 Å. It is a scattering technique that averages information on the entire surface and it is therefore not possible to obtain information within the plane of the interface. The specific properties of neutrons (possibility of tuning the contrast by isotopic substitution, sensitivity to magnetism, negligible absorption, low energy of the incident neutrons makes it particularly interesting in the fields of soft matter, biophysics and magnetic thin films. This course is a basic introduction to the technique and does not address the magnetic reflectivity. It is composed of three parts describing respectively its principle and its formalism, the experimental aspects of the method (spectrometers, samples and two examples related to the materials for energy.
Reis, Shmuel P.
Reflective capacity has been described as an essential characteristic of professionally competent clinical practice, core to ACGME competencies. Reflection has been recently linked to promoting effective use of feedback in medical education and associated with improved diagnostic accuracy, suggesting promising outcomes. There has been a proliferation of reflective writing pedagogy within medical education to foster development of reflective capacity, extend empathy with deepened understanding of patients’ experience of illness, and promote practitioner well-being. At Alpert Med, “interactive” reflective writing with guided individualized feedback from interdisciplinary faculty to students’ reflective writing has been implemented in a Doctoring course and Family Medicine clerkship as an educational method to achieve these aims. Such initiatives, however, raise fundamental questions of reflection definition, program design, efficacy of methods, and outcomes assessment. Within this article, we consider opportunities and challenges associated with implementation of reflective writing curricula for promotion of reflective capacity within medical education. We reflect upon reflection. PMID:20407840
... and affirmation that being attentive along the journey is as important as, and critical to, arriving at ... More and more, development organizations are under pressure to ... is essentially about people relating to each other and their environment.
The nebula Messier 78 takes centre stage in this image taken with the Wide Field Imager on the MPG/ESO 2.2-metre telescope at the La Silla Observatory in Chile, while the stars powering the bright display take a backseat. The brilliant starlight ricochets off dust particles in the nebula, illuminating it with scattered blue light. Igor Chekalin was the overall winner of ESO's Hidden Treasures 2010 astrophotography competition with his image of this stunning object. Messier 78 is a fine example of a reflection nebula. The ultraviolet radiation from the stars that illuminate it is not intense enough to ionise the gas to make it glow - its dust particles simply reflect the starlight that falls on them. Despite this, Messier 78 can easily be observed with a small telescope, being one of the brightest reflection nebulae in the sky. It lies about 1350 light-years away in the constellation of Orion (The Hunter) and can be found northeast of the easternmost star of Orion's belt. This new image of Messier 78 from the MPG/ESO 2.2-metre telescope at the La Silla Observatory is based on data selected by Igor Chekalin in his winning entry to the Hidden Treasures competition . The pale blue tint seen in the nebula in this picture is an accurate representation of its dominant colour. Blue hues are commonly seen in reflection nebulae because of the way the starlight is scattered by the tiny dust particles that they contain: the shorter wavelength of blue light is scattered more efficiently than the longer wavelength red light. This image contains many other striking features apart from the glowing nebula. A thick band of obscuring dust stretches across the image from the upper left to the lower right, blocking the light from background stars. In the bottom right corner, many curious pink structures are also visible, which are created by jets of material being ejected from stars that have recently formed and are still buried deep in dust clouds. Two bright stars, HD 38563A and
Chapple, Rosalie S.; Ramp, Daniel; Bradstock, Ross A.; Kingsford, Richard T.; Merson, John A.; Auld, Tony D.; Fleming, Peter J. S.; Mulley, Robert C.
Effective management of large protected conservation areas is challenged by political, institutional and environmental complexity and inconsistency. Knowledge generation and its uptake into management are crucial to address these challenges. We reflect on practice at the interface between science and management of the Greater Blue Mountains World Heritage Area (GBMWHA), which covers approximately 1 million hectares west of Sydney, Australia. Multiple government agencies and other stakeholders are involved in its management, and decision-making is confounded by numerous plans of management and competing values and goals, reflecting the different objectives and responsibilities of stakeholders. To highlight the complexities of the decision-making process for this large area, we draw on the outcomes of a recent collaborative research project and focus on fire regimes and wild-dog control as examples of how existing knowledge is integrated into management. The collaborative research project achieved the objectives of collating and synthesizing biological data for the region; however, transfer of the project's outcomes to management has proved problematic. Reasons attributed to this include lack of clearly defined management objectives to guide research directions and uptake, and scientific information not being made more understandable and accessible. A key role of a local bridging organisation (e.g., the Blue Mountains World Heritage Institute) in linking science and management is ensuring that research results with management significance can be effectively transmitted to agencies and that outcomes are explained for nonspecialists as well as more widely distributed. We conclude that improved links between science, policy, and management within an adaptive learning-by-doing framework for the GBMWHA would assist the usefulness and uptake of future research.
Gandhi, Rajiv; Davey, John Roderick; Mahomed, Nizar
We examined the relationship between patient expectations of total joint arthroplasty and functional outcomes. We surveyed 1799 patients undergoing primary hip or knee arthroplasty for demographic data and Western Ontario McMaster University Osteoarthritis Index scores at baseline, 3 months, and 1 year of follow-up. Patient expectations were determined with 3 survey questions. The patients with the greatest expectations of surgery were younger, male, and had a lower body mass index. Linear regression modeling showed that a greater expectation of pain relief with surgery independently predicted greater reported pain relief at 1 year of follow-up, adjusted for all relevant covariates (P relief after joint arthroplasty is an important predictor of outcomes at 1 year.
Socio-economic considerations of better air quality on the Greater Vancouver population and economy were discussed. The purpose of the study was to provide socio-economic information to staff and stakeholders of the Greater Vancouver Regional District (GVRD) who are participating in an Air Quality Management Plan (AQMP) development process and the Sustainable Region Initiative (SRI) process. The study incorporated the following methodologies: identification and review of Canadian, American, and European quantitative socio-economic, cost-benefit, cost effectiveness, competitiveness and health analyses of changes in air quality and measures to improve air quality; interviews with industry representatives in Greater Vancouver on competitiveness impacts of air quality changes and ways to improve air quality; and a qualitative analysis and discussion of secondary quantitative information that identifies and evaluates socio-economic impacts arising from changes in Greater Vancouver air quality. The study concluded that for the Greater Vancouver area, the qualitative analysis of an improvement in Greater Vancouver air quality shows positive socio-economic outcomes, as high positive economic efficiency impacts are expected along with good social quality of life impacts. 149 refs., 30 tabs., 6 appendices
Mallow, Michael; Nazarian, Levon N
Lateral hip pain, or greater trochanteric pain syndrome, is a commonly seen condition; in this article, the relevant anatomy, epidemiology, and evaluation strategies of greater trochanteric pain syndrome are reviewed. Specific attention is focused on imaging of this syndrome and treatment techniques, including ultrasound-guided interventions. Copyright © 2014 Elsevier Inc. All rights reserved.
Full Text Available A 48-year-old woman sustained simultaneous isolated bilateral greater trochanteric fracture, following a road traffic accident. The patient presented to us 1 month after the injury. She presented with complaints of pain in the left hip and inability to walk. Roentgenograms revealed displaced comminuted bilateral greater trochanter fractures. The fracture of the left greater trochanter was reduced and fixed internally using the tension band wiring technique. The greater trochanter fracture on the right side was asymptomatic and was managed conservatively. The patient regained full range of motion and use of her hips after a postoperative follow-up of 6 months. Isolated fractures of the greater trochanter are unusual injuries. Because of their relative rarity and the unsettled controversy regarding their etiology and pathogenesis, several methods of treatment have been advocated. Furthermore, the reports of this particular type of injury are not plentiful and the average textbook coverage afforded to this entity is limited. In our study we discuss the mechanism of injury and the various treatment options available.
Parrish, R. Gibson
An ideal population health outcome metric should reflect a population's dynamic state of physical, mental, and social well-being. Positive health outcomes include being alive; functioning well mentally, physically, and socially; and having a sense of well-being. Negative outcomes include death, loss of function, and lack of well-being. In contrast to these health outcomes, diseases and injuries are intermediate factors that influence the likelihood of achieving a state of health. On the basis...
Zanella, F. P.; Magalhaes, D. V.; Oliveira, M. M.; Bianchi, R. F.; Misoguti, L.; Mendonca, C. R.
Describes the total internal reflection process that occurs when the internal angle of incidence is equal to or greater than the critical angle. Presents a demonstration of the effect of frustrated total internal reflection (FTIR). (YDS)
Landsman, M L; Knop, N; Kwant, G; Mook, G A; Zijlstra, W G
A catheter tip oximeter is described consisting of a cardiac catheter containing optical fibers, and incandescent light source, a light detection unit and a processing unit. Half of the optical fibers guide the light to the blood at the tip of the catheter, the other half the backscattered (reflected) light to the detection unit. The detection unit contains a dichroic mirror, transmitting most of the light with lambda less than 800 nm and reflecting most of the light with lambda greater than 900 nm, thus splitting the light into two beams. These pass through interference filters with nominal wavelengths of 640 and 920 nm respectively, and are focused on silicium barrier layer photocells. The photocell signals are amplified and fed into a divider giving the ratio of measuring (R640) and compensating (R920) photocell output. The relationship between log R640/R920 and oxygen saturation is represented by a slightly curved line. The relation may be linearized by subtracting a constant voltage from the divided output before taking the logarithm. The slope of the calibration line is dependent on the total haemoglobin concentration. Nonetheless an average calibration line can be used between 70 and 100% oxygen saturation. For 78 measurements of pig blood samples in this range (haemoglobin concentration between 96 and 161 g.1(-1)), the standard deviation of the difference between the fiberoptic oximeter and a Radiometer OSM1 oxygen saturation meter was 1.9% saturation, for 152 samples over the entire saturation range the standard deviation of the difference was 3.1% saturation. The influence of the flow velocity of blood on the light reflection depends on wavelength as well as on oxygen saturation. Therefore, complete compensation for the flow effect is not possible by simple means.
Achilles, C. M.
The concept of reflective practice and teaching people to be reflective practitioners is examined. The document begins with a look at professional knowledge according to three prominent professionals in the educational administration field: Schon, Schein, and Achilles. "Reflective" strategies that could be incorporated into courses and…
Improvements in butterfly valves, particularly in the areas of automatic control and leak tightness are described. The use of butterfly valves in nuclear power plants is discussed. These uses include service in component cooling, containment cooling, and containment isolation. The outlook for further improvements and greater uses is examined. (U.S.)
This paper provides an historical analysis of the concept of Greater Somalia, the nationalist project that advocates the political union of all Somali-speaking people, including those inhabiting areas in current Djibouti, Ethiopia and Kenya. The Somali territorial unification project of “lost...
Since the beginning of the Eighties, the association of communities of Greater Hanover has dealt intensively with energy and ecopolitical questions in the scope of regional planning. Renewable energy sources play a dominant role in this context. This brochure is the third contribution to the subject ''Energy policy and environmental protection''. Experts as well as possibly interested parties are addressed especially. For all 8 contributions contained, separate entries have been recorded in this database. (BWI) [de
Frank, Morgan R.; Sun, Lijun; Cebrian, Manuel; Youn, Hyejin; Rahwan, Iyad
The city has proven to be the most successful form of human agglomeration and provides wide employment opportunities for its dwellers. As advances in robotics and artificial intelligence revive concerns about the impact of automation on jobs, a question looms: How will automation affect employment in cities? Here, we provide a comparative picture of the impact of automation across U.S. urban areas. Small cities will undertake greater adjustments, such as worker displacement and job content su...
Miller, Jonas G.; Kahle, Sarah; Hastings, Paul D.
Vagal tone is widely believed to be an important physiological aspect of emotion regulation and associated positive behaviors. However, there is inconsistent evidence for relations between children’s baseline vagal tone and their helpful or prosocial responses to others (Hastings & Miller, 2014). Recent work in adults suggests a quadratic association (inverted U-shape curve) between baseline vagal tone and prosociality (Kogan et al., 2014). The present research examined whether this nonlinear association was evident in children. We found consistent evidence for a quadratic relation between vagal tone and prosociality across 3 samples of children using 6 different measures. Compared to low and high vagal tone, moderate vagal tone in early childhood concurrently predicted greater self-reported prosociality (Study 1), observed empathic concern in response to the distress of others and greater generosity toward less fortunate peers (Study 2), and longitudinally predicted greater self-, mother-, and teacher-reported prosociality 5.5 years later in middle childhood (Study 3). Taken together, our findings suggest that moderate vagal tone at rest represents a physiological preparedness or tendency to engage in different forms of prosociality across different contexts. Early moderate vagal tone may reflect an optimal balance of regulation and arousal that helps prepare children to sympathize, comfort, and share with others. PMID:27819463
Gregersen, Nerine; Lampret, Julie; Lane, Tony; Christianson, Arnold
The Greater Sekhukhune-CAPABILITY Outreach Project was undertaken in a rural district in Limpopo, South Africa, as part of the European Union-funded CAPABILITY programme to investigate approaches for capacity building for the translation of genetic knowledge into care and prevention of congenital disorders. Based on previous experience of a clinical genetic outreach programme in Limpopo, it aimed to initiate a district clinical genetic service in Greater Sekhukhune to gain knowledge and experience to assist in the implementation and development of medical genetic services in South Africa. Implementing the service in Greater Sekhukhune was impeded by a developing staff shortage in the province and pressure on the health service from the existing HIV/AIDS and TB epidemics. This situation underscores the need for health needs assessment for developing services for the care and prevention of congenital disorders in middle- and low-income countries. However, these impediments stimulated the pioneering of innovate ways to offer medical genetic services in these circumstances, including tele-teaching of nurses and doctors, using cellular phones to enhance clinical care and adapting and assessing the clinical utility of a laboratory test, QF-PCR, for use in the local circumstances.
Dickman, P.T.; Vollmer, A.T.; Hunter, P.H.
Procedures and methods for the design and operation of a greater confinement disposal facility using large-diameter boreholes are discussed. It is assumed that the facility would be located at an operating low-level waste disposal site and that only a small portion of the wastes received at the site would require greater confinement disposal. The document is organized into sections addressing: facility planning process; facility construction; waste loading and handling; radiological safety planning; operations procedures; and engineering cost studies. While primarily written for low-level waste management site operators and managers, a detailed economic assessment section is included that should assist planners in performing cost analyses. Economic assessments for both commercial and US government greater confinement disposal facilities are included. The estimated disposal costs range from $27 to $104 per cubic foot for a commercial facility and from $17 to $60 per cubic foot for a government facility. These costs are based on average site preparation, construction, and waste loading costs for both contact- and remote-handled wastes. 14 figures, 22 tables
R. Veenhoven (Ruut)
textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the happiness of the great number could not be measured
R. Veenhoven (Ruut); E. Samuel (Emad)
textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time, the happiness of the great number could not be
R. Veenhoven (Ruut)
textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the Happiness of the great number could not be measured
The need for greater stability in nuclear regulation is discussed. Two possible approaches for dealing with the problems of new and rapidly changing regulatory requirements are discussed. The first approach relies on the more traditional licensing reform initiatives that have been considered off and on for the past decade. The second approach considers a new regulator philosophy aimed at the root causes of the proliferation of new safety requirements that have been imposed in recent years. For the past few years, the concepts of deregulation and regulatory reform have been in fashion in Washington, and the commercial nuclear power program has not remained unaffected. Many look to these concepts to provide greater stability in the regulatory program. The NRC, the nuclear industry and the administration have all been avidly pursuing regulatory reform initiatives, which take the form of both legislative and administrative proposals. Many of these proposals look to the future, and, if adopted, would have little impact on currently operating nuclear power plants or plants now under construction
Reducing the amount of fuel that people use for personal driving saves money, improves local air quality, and reduces personal contributions to climate change. This handbook was developed to be used as a tool for a fuel efficient driving pilot program in Greater Sudbury in 2009-2010. Specifically, the purpose of the handbook was to provide greater Sudbury drivers with information on how to drive and maintain their personal vehicles in order to maximize fuel efficiency. The handbook also provides tips for purchasing fuel efficient vehicles. It outlines the benefits of fuel maximization, with particular reference to reducing contributions to climate change; reducing emissions of air pollutants; safe driving; and money savings. Some tips for efficient driving are to avoid aggressive driving; use cruise control; plan trips; and remove excess weight. Tips for efficient winter driving are to avoid idling to warm up the engine; use a block heater; remove snow and ice; use snow tires; and check tire pressure. The importance of car maintenance and tire pressure was emphasized. The handbook also explains how fuel consumption ratings are developed by vehicle manufacturers. refs., figs.
Although many people believe that mainly men get infected with HIV/AIDS, women are actually getting infected at a faster rate than men, especially in developing countries, and suffer more from the adverse impact of AIDS. As of mid-1996, the Joint UN Program on AIDS estimated that more than 10 million of the 25 million adults infected with HIV since the beginning of the epidemic are women. The proportion of HIV-positive women is growing, with almost half of the 7500 new infections daily occurring among women. 90% of HIV-positive women live in a developing country. In Asia-Pacific, 1.4 million women have been infected with HIV out of an estimated total 3.08 million adults from the late 1970s until late 1994. Biologically, women are more vulnerable than men to infection because of the greater mucus area exposed to HIV during penile penetration. Women under age 17 years are at even greater risk because they have an underdeveloped cervix and low vaginal mucus production. Concurrent sexually transmitted diseases increase the risk of HIV transmission. Women's risk is also related to their exposure to gender inequalities in society. The social and economic pressures of poverty exacerbate women's risk. Prevention programs are discussed.
Fertner, Christian; Jørgensen, Gertrud; Nielsen, Thomas Alexander Sick
development plans. Land use scenarios based on empirically derived dynamics of urban growth are practically never applied. This may be explained by the in-consistency between the logic of spatial master planning - and the organic or driver-dependent character of urban growth assumed by land use modelling...... approaches. However, modelling approaches do offer a methodology to explore the pressures in an urban region, as well as an approach to understand urban development patterns outside the ‘spatial masterplan’. In this context we will present the results of a modelling exercise addressing future land use change......Urban planning and development in Denmark can be characterised by a relatively strong planning framework. Projections of the future demand for urban development as well as decisions on how and where to accommodate this demand is part of the planning process and reflected in strategic- and local...
Frank, Morgan R; Sun, Lijun; Cebrian, Manuel; Youn, Hyejin; Rahwan, Iyad
The city has proved to be the most successful form of human agglomeration and provides wide employment opportunities for its dwellers. As advances in robotics and artificial intelligence revive concerns about the impact of automation on jobs, a question looms: how will automation affect employment in cities? Here, we provide a comparative picture of the impact of automation across US urban areas. Small cities will undertake greater adjustments, such as worker displacement and job content substitutions. We demonstrate that large cities exhibit increased occupational and skill specialization due to increased abundance of managerial and technical professions. These occupations are not easily automatable, and, thus, reduce the potential impact of automation in large cities. Our results pass several robustness checks including potential errors in the estimation of occupational automation and subsampling of occupations. Our study provides the first empirical law connecting two societal forces: urban agglomeration and automation's impact on employment. © 2018 The Authors.
Sun, Lijun; Cebrian, Manuel; Rahwan, Iyad
The city has proved to be the most successful form of human agglomeration and provides wide employment opportunities for its dwellers. As advances in robotics and artificial intelligence revive concerns about the impact of automation on jobs, a question looms: how will automation affect employment in cities? Here, we provide a comparative picture of the impact of automation across US urban areas. Small cities will undertake greater adjustments, such as worker displacement and job content substitutions. We demonstrate that large cities exhibit increased occupational and skill specialization due to increased abundance of managerial and technical professions. These occupations are not easily automatable, and, thus, reduce the potential impact of automation in large cities. Our results pass several robustness checks including potential errors in the estimation of occupational automation and subsampling of occupations. Our study provides the first empirical law connecting two societal forces: urban agglomeration and automation's impact on employment. PMID:29436514
Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.
This contribution is a progress report for preparation of a document that will summarize procedures and technical information needed to plan for and implement greater-confinement disposal (GCD) of low-level radioactive waste. Selection of a site and a facility design (Phase I), and construction, operation, and extended care (Phase II) will be covered in the document. This progress report is limited to Phase I. Phase I includes determination of the need for GCD, design alternatives, and selection of a site and facility design. Alternative designs considered are augered shafts, deep trenches, engineered structures, high-integrity containers, hydrofracture, and improved waste form. Design considerations and specifications, performance elements, cost elements, and comparative advantages and disadvantages of the different designs are covered. Procedures are discussed for establishing overall performance objectives and waste-acceptance criteria, and for comparative assessment of the performance and cost of the different alternatives. 16 references
Trevorrow, L.E.; Gilbert, T.L.; Luner, C.; Merry-Libby, P.A.; Meshkov, N.K.; Yu, C.
Low-level radioactive waste (LLW) includes a broad spectrum of different radionuclide concentrations, half-lives, and hazards. Standard shallow-land burial practice can provide adequate protection of public health and safety for most LLW. A small volume fraction (approx. 1%) containing most of the activity inventory (approx. 90%) requires specific measures known as greater-confinement disposal (GCD). Different site characteristics and different waste characteristics - such as high radionuclide concentrations, long radionuclide half-lives, high radionuclide mobility, and physical or chemical characteristics that present exceptional hazards - lead to different GCD facility design requirements. Facility design alternatives considered for GCD include the augered shaft, deep trench, engineered structure, hydrofracture, improved waste form, and high-integrity container. Selection of an appropriate design must also consider the interplay between basic risk limits for protection of public health and safety, performance characteristics and objectives, costs, waste-acceptance criteria, waste characteristics, and site characteristics
Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.
This contribution is a progress report for preparation of a document that will summarize procedures and technical information needed to plan for and implement greater-confinement disposal (GCD) of low-level radioactive waste. Selection of a site and a facility design (Phase I), and construction, operation, and extended care (Phase II) will be covered in the document. This progress report is limited to Phase I. Phase I includes determination of the need for GCD, design alternatives, and selection of a site and facility design. Alternative designs considered are augered shafts, deep trenches, engineered structures, high-integrity containers, hydrofracture, and improved waste form. Design considerations and specifications, performance elements, cost elements, and comparative advantages and disadvantages of the different designs are covered. Procedures are discussed for establishing overall performance objecties and waste-acceptance criteria, and for comparative assessment of the performance and cost of the different alternatives. 16 refs
Clark, Phillip G
Interprofessional education (IPE) involves learning, and learning requires reflection. Educators need to "reflect more on reflection" if they are to be effective teachers in ensuring the learning outcomes essential for teamwork and interprofessional practice (IPP), including incorporating both theory and practice into the development of educational interventions. First, this discussion surveys the IPE-relevant literature on reflection, and then defines and refines the multidimensional concept of reflection as it relates to IPE in developing and implementing teamwork learning programs and experiences. Second, specific methods to promote reflection are presented and explored, including self-assessments, journaling, and written papers. Actual samples from student journals and assignments provide examples of the impacts of using these methods on participant reflection and learning. Finally, implications for an expanded understanding and application of reflection for IPE will be discussed, and recommendations made for educational practice and research in this area.
Berger, Joel; Beckmann, Jon P
In the United States, as elsewhere, a growing debate pits national energy policy and homeland security against biological conservation. In rural communities the extraction of fossil fuels is often encouraged because of the employment opportunities it offers, although the concomitant itinerant workforce is often associated with increased wildlife poaching. We explored possible positive and negative factors associated with energy extraction in the Greater Yellowstone Ecosystem (GYE), an area known for its national parks, intact biological diversity, and some of the New World's longest terrestrial migrations. Specifically, we asked whether counties with different economies-recreation (ski), agrarian (ranching or farming), and energy extractive (petroleum)-differed in healthcare (gauged by the abundance of hospital beds) and in the frequency of sexual predators. The absolute and relative frequency of registered sex offenders grew approximately two to three times faster in areas reliant on energy extraction. Healthcare among counties did not differ. The strong conflation of community dishevel, as reflected by in-migrant sexual predators, and ecological decay in Greater Yellowstone is consistent with patterns seen in similar systems from Ecuador to northern Canada, where social and environmental disarray exist around energy boomtowns. In our case, that groups (albeit with different aims) mobilized campaigns to help maintain the quality of rural livelihoods by protecting open space is a positive sign that conservation can matter, especially in the face of rampant and poorly executed energy extraction projects. Our findings further suggest that the public and industry need stronger regulatory action to instill greater vigilance when and where social factors and land conversion impact biological systems.
Giri, Chandra; Jenkins, Clinton N.
A new land cover database of Greater Mesoamerica has been prepared using moderate resolution imaging spectroradiometer (MODIS, 500 m resolution) satellite data. Daily surface reflectance MODIS data and a suite of ancillary data were used in preparing the database by employing a decision tree classification approach. The new land cover data are an improvement over traditional advanced very high resolution radiometer (AVHRR) based land cover data in terms of both spatial and thematic details. The dominant land cover type in Greater Mesoamerica is forest (39%), followed by shrubland (30%) and cropland (22%). Country analysis shows forest as the dominant land cover type in Belize (62%), Cost Rica (52%), Guatemala (53%), Honduras (56%), Nicaragua (53%), and Panama (48%), cropland as the dominant land cover type in El Salvador (60.5%), and shrubland as the dominant land cover type in Mexico (37%). A three-step approach was used to assess the quality of the classified land cover data: (i) qualitative assessment provided good insight in identifying and correcting gross errors; (ii) correlation analysis of MODIS- and Landsat-derived land cover data revealed strong positive association for forest (r2 = 0.88), shrubland (r2 = 0.75), and cropland (r2 = 0.97) but weak positive association for grassland (r2 = 0.26); and (iii) an error matrix generated using unseen training data provided an overall accuracy of 77.3% with a Kappa coefficient of 0.73608. Overall, MODIS 500 m data and the methodology used were found to be quite useful for broad-scale land cover mapping of Greater Mesoamerica.
Lee, D.S.; Longhurst, J.W.S.; Gee, D.R.; Hare, S.E. (Manchester Polytechnic, Manchester (UK). Acid Rain Information Centre)
Data are presented from a monitoring network of 18 bulk precipitation collectors and one wet-only collector in the urban area of Greater Manchester, in the north west of England. Weekly samples were analysed for all the major ions in precipitation along with gaseous nitrogen dioxide concentrations from diffusion tubes. Statistical analysis of the data shows significant spatial variation of non marine sulphate, nitrate, ammonium, acidity and calcium concentrations, and nitrogen dioxide concentrations. Calcium is thought to be responsible for the buffering of acidity and is of local origin. Wet deposition is the likely removal process for calcium in the atmosphere and probably by below cloud scavenging. Nitrate and ammonium concentrations and depositions show close spatial, temporal and statistical association. Examination of high simultaneous episodes of nitrate and ammonium deposition shows that these depositions cannot be explained in terms of trajectories and it is suggested that UK emissions of ammonia may be important. Statistical analysis of the relationships between nitrate and ammonium depositions, concentrations and precipitation amount suggest that ammonia from mesoscale sources reacts reversibly with nitric acid aerosol and is removed by below cloud scavenging. High episodes of the deposition of non marine sulphate are difficult to explain by trajectory analysis alone, perhaps suggesting local sources. In a comparison between wet deposition and bulk deposition, it was shown that only 15.2% of the non marine sulphur was dry deposited to the bulk precipitation collector. 63 refs., 86 figs., 31 tabs.
Rifkin-Graboi, Anne; Quan, Jeffry; Richmond, Jenny; Goh, Shaun Kok Yew; Sim, Lit Wee; Chong, Yap Seng; Francois-Bureau, Jean; Chen, Helen; Qiu, Anqi
Poor early life care often relates to cognitive difficulties. However, newer work suggests that in early-life, adversity may associate with enhanced or accelerated neurodevelopment. We examine associations between postnatal caregiving risks (i.e., higher self-reported postnatal-anxiety and lower observed maternal sensitivity) and infant relational memory (i.e. via deferred imitation and relational binding). Using subsamples of 67-181 infants (aged 433-477 post-conceptual days, or roughly five to seven months since birth) taking part in the GUSTO study, we found such postnatal caregiving risk significantly predictive of "better" performance on a relational binding task following a brief delay, after Bonferroni adjustments. Subsequent analyses suggest that the association between memory and these risks may specifically be apparent amongst infants spending at least 50% of their waking hours in the presence of their mothers. Our findings echo neuroimaging research concerning similar risk exposure and larger infant hippocampal volume, and likewise underscore the importance of considering developmental context in understanding early life experience. With this in mind, these findings caution against the use of cognitive outcomes as indices of experienced risk. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.
McGady, David A.
-temperature path integrals for quantum field theories (QFTs) should be T-reflection invariant. Because multi-particle partition functions are equal to Euclidean path integrals for QFTs, we expect them to be T-reflection invariant. Single-particle partition functions though are often not invariant under T......In this paper, we revisit the claim that many partition functions are invariant under reflecting temperatures to negative values (T-reflection). The goal of this paper is to demarcate which partition functions should be invariant under T-reflection, and why. Our main claim is that finite...... that T-reflection is unrelated to time-reversal. Finally, we study the interplay between T-reflection and perturbation theory in the anharmonic harmonic oscillator in quantum mechanics and in Yang-Mills in four-dimensions. This is the first in a series of papers on temperature-reflections....
Horell, Harold D.
The author argues that if we are to foster life-giving and liberating moral reflection, we must first liberate moral reflection from distortions; specifically, from the distorting effects of moral insensitivity, destructive moral relativism, and confusions resulting from a failure to understand the dynamics of moral reflection. The author proposes…
Weber, M.; Tang, S.; Khatri, R.; Roellig, L.O.; Viescas, A.J.; Berko, S.; Canter, K.F.; Lynn, K.G.; Mills, A.P. Jr.
We have observed specular reflection of positronium, Ps, and established that there is adequate intensity at higher energies to make further study worthwhile. The scattering appears to be restricted to the outermost surface with a mean free path of (0.75 ± 0.15)Angstrom for Ps in LiF(100). With a greater intensity Ps beam one should see higher order diffraction beams as the result of the periodicity of the surface. Ps diffraction thus offers the possibility of being a novel and valuable probe to study the outermost surface and to study adsorbents on it. Two methods for producing Ps beams are described. 29 refs., 11 figs
The Greater Dead Sea Basin (GDSB) is a 220km long depression situated along the southern section of the Dead Sea Transform (DST), between two structurally and gravitationally elevated points, Wadi Malih in the north and Paran fault zone in the south. In its center is the Dead Sea basin 'sensu strictu' (DSB), which has been described since the 1970s as a pull-apart basin at a left step-over along the DST. However, several observations, or their lack thereof, contradict this scheme, e.g. (i) It is not supported by recent seismological and geomorphic data; (ii) It does not explain the fault pattern and mixed sinistral and dextral offset along the DSB western boundary; (iii) It does not simply explain the presence of intense deformation outside the presumed fault step zone; (iv) It is inconsistent with the orientation of seismically active faults within the Dead Sea and Jericho Valley; (v) The length of the DSB exceeds the total offset along the Dead Sea Transform, while its subsidence is about the age of the DST. In this study, newly acquired and analyzed data (high resolution seismic reflection and earthquake relocation and fault plane solutions) has been integrated with previously published data (structural mapping, fracture orientation distribution, Bouguer anomaly maps, sinkhole distribution, geomorphic lineaments). The results show that the GDSB is dominated by two active fault systems, one trending NNE and showing normal-dextral motion, the other trending NW. These systems are identified by earthquake activity, seismic reflection observations, alignment of recent sinkholes, and distribution of Bouguer anomaly gradients. As a result, the intra-basin structure is of a series of rectangular blocks. The dextral slip component along NNE trending faults, the mixed sense of lateral offset along the western boundary of the DSB and temporal change in fracture orientation in the Jericho Valley suggest that the intra-basin blocks have rotated counterclockwise since the
Kamperschroer, J.H.; Grisham, L.R.; Kugel, H.W.; O'Connor, T.E.; Newman, R.A.; Stevenson, T.N.; von Halle, A.; Williams, M.D.
Determination of two critical neutral beam parameters, power and divergence, are affected by the reflection of a fraction of the incident energy from the surface of the measuring calorimeter. On the TFTR Neutral Beam Test Stand, greater than 30% of the incident power directed at the target chamber calorimeter was unaccounted for. Most of this loss is believed due to reflection from the surface of the flat calorimeter, which was struck at a near grazing incidence (12 degrees). Beamline calorimeters, of a ''V''-shape design, while retaining the beam power, also suffer from reflection effects. Reflection, in this latter case, artificially peaks the power toward the apex of the ''V'', complicating the fitting technique, and increasing the power density on axis by 10 to 20%; an effect of import to future beamline designers. Agreement is found between measured and expected divergence values, even with 24% of the incident energy reflected
Tielidze, Levan G.; Wheate, Roger D.
There have been numerous studies of glaciers in the Greater Caucasus, but none that have generated a modern glacier database across the whole mountain range. Here, we present an updated and expanded glacier inventory at three time periods (1960, 1986, 2014) covering the entire Greater Caucasus. Large-scale topographic maps and satellite imagery (Corona, Landsat 5, Landsat 8 and ASTER) were used to conduct a remote-sensing survey of glacier change, and the 30 m resolution Advanced Spaceborne Thermal Emission and Reflection Radiometer Global Digital Elevation Model (ASTER GDEM; 17 November 2011) was used to determine the aspect, slope and height distribution of glaciers. Glacier margins were mapped manually and reveal that in 1960 the mountains contained 2349 glaciers with a total glacier surface area of 1674.9 ± 70.4 km2. By 1986, glacier surface area had decreased to 1482.1 ± 64.4 km2 (2209 glaciers), and by 2014 to 1193.2 ± 54.0 km2 (2020 glaciers). This represents a 28.8 ± 4.4 % (481 ± 21.2 km2) or 0.53 % yr-1 reduction in total glacier surface area between 1960 and 2014 and an increase in the rate of area loss since 1986 (0.69 % yr-1) compared to 1960-1986 (0.44 % yr-1). Glacier mean size decreased from 0.70 km2 in 1960 to 0.66 km2 in 1986 and to 0.57 km2 in 2014. This new glacier inventory has been submitted to the Global Land Ice Measurements from Space (GLIMS) database and can be used as a basis data set for future studies.
Ajay E. Kuriyan
Full Text Available AIM: To compare thickness and reflectivity spectral domain optical coherence tomography (SD-OCT findings in patients with idiopathic epiretinal membranes (ERMs, before and after ERM peeling surgery, with normal controls. METHODS: A retrospective study analyzed SD-OCTs of eyes with ERMs undergoing ERM peeling surgery by one surgeon from 2008 to 2010 and normal control eyes. SD-OCTs were analyzed using a customized algorithm to measure reflectivity and thickness. The relationship between the SD-OCT findings and best corrected visual acuity (BCVA outcomes was also studied. RESULTS: Thirty-four ERM eyes and 12 normal eyes were identified. Preoperative eyes had high reflectivity and thickness of the group of layers from the internal limiting membrane (ILM to the retinal pigment epithelium (RPE and the group of layers from the ILM to the external limiting membrane (ELM. The values of reflectivity of these two groups of layers decreased postoperatively, but were still higher than normal eyes. In contrast, preoperative eyes had lower reflectivity of two 10×15 pixel regions of interest (ROIs incorporating: 1 ELM + outer nuclear layer (ONL and 2 photoreceptor layer (PRL + RPE, compared to controls. The values of reflectivity of these ROIs increased postoperatively, but were still lower than normal controls. A larger improvement in BCVA postoperatively was correlated with a greater degree of abnormal preoperative reflectivity and thickness findings. CONCLUSION: Quantitative differences in reflectivity and thickness between preoperative, postoperative, and normal SD-OCTs allow assessment of changes in the retina secondary to ERM. Our study identified hyperreflective inner retina changes and hyporeflective outer retina changes in patients with ERMs. SD-OCT quantitative measures of reflectivity and/or thickness of specific groups of retinal layers and/or ROIs correlate with improvement in BCVA.
This article develops the concept media for reflection in the interest of conceptualizing the interpretative frames that enable and limit reflection in management and leadership education. The concept ‘media for reflection’ allows us to conceptualize the social and cultural mediation of reflection...... without reducing reflection to an effect of the social structures and cultural norms in which it is embedded. Based on the developed theoretical framework, this article analyses how a renaissance ‘mirror for princes’ and contemporary research-based management education mediate reflection. The content...... of the mediations is analysed as well as the societal and organizational background. Furthermore, the means by which the two media enable and limit reflection in different ways is compared. Finally, the article discusses possible implications of the analysis in terms of management and leadership education....
This article identifies key characteristics of Masters level writing and the underpinning relationship of these characteristics to reflective thought. Classical models of reflective writing are reviewed and their focus on reflection as a progressive process is debated. A linear model of reflection is proposed and its application to reflective writing for Masters level assessments is examined. The classical authors tend to present reflection as a process in which the outcomes of reflection becomes deeper at advanced levels. While this is an appropriate application of the concept of reflection for the traditional academic essay, it might not always be so appropriate for other more applied aspects of thinking and writing particularly in the development of advanced nursing practice. A linear model of reflective writing which offers a more pragmatic perspective on reflection is developed.
Full Text Available Reflection is an essential attribute for the development of autonomous, critical, and advanced practitioners (Mantzoukas & Jasper, 2004. According to Chong (2009, “Reflective practice should be a continuous cycle in which experience and reflection on experiences are inter-related” (p. 112. Studies have shown that nurses who take the time to reflect on their daily experiences provide enhanced nursing care, have a better understanding of theiractions, which in return develops their professional skills (Hansebo & Kihlgren, 2001. Reflective practice is the ability to examine ones actions and experiences with the outcome of developing their practice and enhancing clinicalknowledge. Reflective practice affects all levels of nursing, from students, to advanced practice nursing students, aswell as practicing nurses. Reflective practice is an important component of the nursing curriculum. Research has shown the relationship between student nurses and their mentors is vital. In order for reflection to be effective open-mindedness, courage, and a willingness to accept, and act on, criticism must be present (Bulmam, Lathlean, & Gobbi, 2012. This paper will explore the current literature and implications related to reflective practice in nursing.
Dunn, Louise; Musolino, Gina M
Facilitation of reflective practice is critical for the ongoing demands of health care practitioners. Reflective thinking concepts, grounded in the work of Dewey and Schön, emphasize critical reflection to promote transformation in beliefs and learning necessary for reflective practice. The Reflective Thinking Questionnaire (QRT) and Revised Study Process Questionnaire (RSPQ-2F) assess skill aspects of professional reasoning, with promise for measuring changes over time. The purpose of this study was to examine the reliability and responsiveness and the model validity of reflective thinking and approaches to learning measures for U.S. health professions students enrolled in entry-level occupational (MOT) and physical therapy (DPT) programs. This measurement study addressed reliability and responsiveness of two measures, the QRT and RSPQ-2F, for graduate health professionals. A convenience sample of 125 MOT and DPT students participated in the two-measure, test-retest investigation, with electronic data collection. Outcomes support the stability of the four-scale QRT (ICC 0.63 to 0.82) and the two-scale RSPQ-2F (ICC 0.91 and 0.87). Descriptive data supporting responsiveness are presented. With noted limitations, the results support the use of the QRT and RSPQ-2F measures to assess changes in reflective thinking and approaches to learning. Measurement of these learning outcomes furthers our understanding and knowledge about instructional strategies, development of professional reasoning, and fostering of self-directed learning within MOT and DPT programs.
Neutron reflection is perhaps the most developed branch of slow neutrons optics, which in itself is a direct consequence of the undulatory nature of the neutron. After reviewing the basic types of interactions (nuclear and magnetic) between neutrons and matter, the formalism is introduced to calculate the reflectivity from a sample composed of stacked flat layers and, inversely, to calculate the stacking from reflectivity measurements. Finally, a brief survey of the applications of neutron reflection is given, both in technology and in fundamental research. 32 refs., 6 figs
Haire, M.J.; Jordan, W.C.; Taylor, R.G.
The assumptions used for reflection conditions of single containers are fairly well established and consistently applied throughout the industry in nuclear criticality safety evaluations. Containers are usually considered to be either fully water-reflected (i.e. surrounded by 6 to 12 in. of water) for safety calculations or reflected by 1 in. of water for nominal (structural material and air) conditions. Tables and figures are usually available for performing comparative evaluations of containers under various loading conditions. Reflection considerations used for evaluating the safety of storage arrays of fissile material are not as well established
Kessler, Penny D; Lund, Carole H
Reflective journal writing can be a useful heuristic tool to foster critical thinking skills and develop reflective clinical practice in nursing. When combined with a distance education delivery format, the online journal helps to leverage the strengths of reflective learning with educational technology as well as provide a seamless record of learning outcomes across the curriculum. The authors discuss the incorporation of an online reflective journal into a distance education clinical course and provide guidelines for educators considering a similar approach.
Zeman, P; Rafi, M; Skala, P; Zeman, J; Matějka, J; Pavelka, T
PURPOSE OF THE STUDY This retrospective study aims to present short-term clinical outcomes of endoscopic treatment of patients with greater trochanteric pain syndrome (GTPS). MATERIAL AND METHODS The evaluated study population was composed of a total of 19 patients (16 women, 3 men) with the mean age of 47 years (19-63 years). In twelve cases the right hip joint was affected, in the remaining seven cases it was the left side. The retrospective evaluation was carried out only in patients with greater trochanteric pain syndrome caused by independent chronic trochanteric bursitis without the presence of m. gluteus medius tear not responding to at least 3 months of conservative treatment. In patients from the followed-up study population, endoscopic trochanteric bursectomy was performed alone or in combination with iliotibial band release. The clinical results were evaluated preoperatively and with a minimum follow-up period of 1 year after the surgery (mean 16 months). The Visual Analogue Scale (VAS) for assessment of pain and WOMAC (Western Ontario MacMaster) score were used. In both the evaluated criteria (VAS and WOMAC score) preoperative and postoperative results were compared. Moreover, duration of surgery and presence of postoperative complications were assessed. Statistical evaluation of clinical results was carried out by an independent statistician. In order to compare the parameter of WOMAC score and VAS pre- and post-operatively the Mann-Whitney Exact Test was used. The statistical significance was set at 0.05. RESULTS The preoperative VAS score ranged 5-9 (mean 7.6) and the postoperative VAS ranged 0-5 (mean 2.3). The WOMAC score ranged 56.3-69.7 (mean 64.2) preoperatively and 79.8-98.3 (mean 89.7) postoperatively. When both the evaluated parameters of VAS and WOMAC score were compared in time, a statistically significant improvement (ppain syndrome yields statistically significant improvement of clinical results with the concurrent minimum incidence of
Bjørn, Pernille; Boulus, Nina
Reflective monitoring of research practices is essential. However, we often lack formal training in the practices of doing action research, and descriptions of actual inquiry practice are seldom included in publications. Our aim is to provide a glimpse of self-reflective practices based on our...
will take a look at the establishing of the modern self and possibilities of self-reflection, too. My examples will be from the so-called dark-selfies and from a new selfie form, which merge the present with the previous progressing into the future. I will discuss the media reflections as loos and/or gain...
Van Seggelen-Damen, Inge C M; Van Hezewijk, René; Helsdingen, Anne S; Wopereis, Iwan G J H
Reflection is a fuzzy concept. In this article we reveal the paradoxes involved in studying the nature of reflection. Whereas some scholars emphasize its discursive nature, we go further and underline its resemblance to the self-biased dialogue Socrates had with the slave in Plato's Meno . The individual and internal nature of the reflection process creates difficulty for studying it validly and reliably. We focus on methodological issues and use Hans Linschoten's view of coupled systems to identify, analyze, and interpret empirical research on reflection. We argue that researchers and research participants can take on roles in several possible system couplings. Depending on who controls the manipulation of the stimulus, who controls the measuring instrument, who interprets the measurement and the response, different types of research questions can be answered. We conclude that reflection may be validly studied by combining different couplings of experimenter, manipulation, stimulus, participant, measurement, and response.
Graham, John R; Shier, Micheal L; Nicholas, David
Workplace expectations reflect an important consideration in employee experience. A higher prevalence of workplace congruence between worker and employer expectations has been associated with higher levels of productivity and overall workplace satisfaction across multiple occupational groups. Little research has investigated the relationship between workplace congruence and occupational health outcomes among social service workers. This study sought to better understand the extent to which occupational congruence contributes to occupational outcomes by surveying unionised social service workers ( n = 674) employed with the Government of Alberta, Canada. Multiple regression analysis shows that greater congruence between workplace and worker expectations around workloads, workplace values and the quality of the work environment significantly: (i) decreases symptoms related to distress and secondary traumatic stress; (ii) decreases intentions to leave; and (iii) increases overall life satisfaction. The findings provide some evidence of areas within the workplace of large government run social welfare programmes that can be better aligned to worker expectations to improve occupational outcomes among social service workers.
Full Text Available Scores on the three-item Cognitive Reflection Test (CRT have been linked with dual-system theory and normative decision making (Frederick, 2005. In particular, the CRT is thought to measure monitoring of System 1 intuitions such that, if cognitive reflection is high enough, intuitive errors will be detected and the problem will be solved. However, CRT items also require numeric ability to be answered correctly and it is unclear how much numeric ability vs. cognitive reflection contributes to better decision making. In two studies, CRT responses were used to calculate Cognitive Reflection and numeric ability; a numeracy scale was also administered. Numeric ability, measured on the CRT or the numeracy scale, accounted for the CRT’s ability to predict more normative decisions (a subscale of decision-making competence, incentivized measures of impatient and risk-averse choice, and self-reported financial outcomes; Cognitive Reflection contributed no independent predictive power. Results were similar whether the two abilities were modeled (Study 1 or calculated using proportions (Studies 1 and 2. These findings demonstrate numeric ability as a robust predictor of superior decision making across multiple tasks and outcomes. They also indicate that correlations of decision performance with the CRT are insufficient evidence to implicate overriding intuitions in the decision-making biases and outcomes we examined. Numeric ability appears to be the key mechanism instead.
Sinayev, Aleksandr; Peters, Ellen
Scores on the three-item Cognitive Reflection Test (CRT) have been linked with dual-system theory and normative decision making (Frederick, 2005). In particular, the CRT is thought to measure monitoring of System 1 intuitions such that, if cognitive reflection is high enough, intuitive errors will be detected and the problem will be solved. However, CRT items also require numeric ability to be answered correctly and it is unclear how much numeric ability vs. cognitive reflection contributes to better decision making. In two studies, CRT responses were used to calculate Cognitive Reflection and numeric ability; a numeracy scale was also administered. Numeric ability, measured on the CRT or the numeracy scale, accounted for the CRT's ability to predict more normative decisions (a subscale of decision-making competence, incentivized measures of impatient and risk-averse choice, and self-reported financial outcomes); Cognitive Reflection contributed no independent predictive power. Results were similar whether the two abilities were modeled (Study 1) or calculated using proportions (Studies 1 and 2). These findings demonstrate numeric ability as a robust predictor of superior decision making across multiple tasks and outcomes. They also indicate that correlations of decision performance with the CRT are insufficient evidence to implicate overriding intuitions in the decision-making biases and outcomes we examined. Numeric ability appears to be the key mechanism instead.
Haire, M.J.; Jordan, W.C.; Taylor, R.G.
The assumptions used for reflection conditions of single containers are fairly well established and consistently applied throughout the industry in nuclear criticality safety evaluations. Containers are usually considered to be either fully water reflected (i.e., surrounded by 6 to 12 in. of water) for safety calculations or reflected by 1 in. of water for nominal (structural material and air) conditions. Tables and figures are usually available for performing comparative evaluations of containers under various loading conditions. Reflection considerations used for evaluating the safety of storage arrays of fissile material are not as well established. When evaluating arrays, it has become more common for analysts to use calculations to demonstrate the safety of the array configuration. In performing these calculations, the analyst has considerable freedom concerning the assumptions made for modeling the reflection of the array. Considerations are given for the physical layout of the array with little or no discussion (or demonstration) of what conditions are bounded by the assumed reflection conditions. For example, an array may be generically evaluated by placing it in a corner of a room in which the opposing walls are far away. Typically, it is believed that complete flooding of the room is incredible, so the array is evaluated for various levels of water mist interspersed among array containers. This paper discusses some assumptions that are made regarding storage array reflection
Recommendations for an update of the 2010 European regulatory guideline on clinical investigation of medicinal products used in the treatment of osteoarthritis and reflections about related clinically relevant outcomes: expert consensus statement.
Reginster, J-Y; Reiter-Niesert, S; Bruyère, O; Berenbaum, F; Brandi, M-L; Branco, J; Devogelaer, J-P; Herrero-Beaumont, G; Kanis, J; Maggi, S; Maheu, E; Richette, P; Rizzoli, R; Cooper, C
The European Society on Clinical and Economic aspects of Osteoporosis and Osteoarthritis (ESCEO) organised a working group to evaluate the need for updating the current European guideline on clinical investigation of drugs used in the treatment of osteoarthritis (OA). Areas of potential attention were identified and the need for modifications, update or clarification was examined. Proposals were then developed based on literature reviews and through a consensus process. It was agreed that the current guideline overall still reflects the current knowledge in OA, although two possible modifications were identified. The first relates to the number and timing of measurements required as primary endpoints during clinical trials of symptom-relieving drugs, either drugs with rapid onset of action or slow acting drugs. The suggested modifications are intended to take into consideration the time related clinical need and expected time response to these drugs - i.e., a more early effect for the first category in addition to the maintenance of effect, a more continuous benefit over the long-term for the latter - in the timing of assessments. Secondly, values above which a benefit over placebo should be considered clinically relevant were considered. Based on literature reviews, the most consensual values were determined for primary endpoints of both symptom-relieving drugs (i.e., pain intensity on a visual analogue scale (VAS)) and disease-modifying drugs (i.e., radiographic joint-space narrowing). This working document might be considered by the European regulatory authorities in a future update of the guideline for the registration of drugs in OA. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Vink, P.; Koningsveld, E.A.P.; Molenbroek, J.F.
Ergonomics sometimes has a negative connotation, as it is seen to be connected to illness or guidelines that limit innovations. This paper is focused on the positive aspects of ergonomics in improvement of the working environment. It consists of a part that studies the literature on success factors
Lunde Jørgensen, Ida
Private foundations and cultural philanthropy by élites is viewed with increasing skepticism in recent years, begging the question of the extent to which foundations reflect on their role vis a vis wider societal norms. Through the prism of the New Carlsberg Foundation, financed by the brewery...... Carlsberg A/S, the paper seeks to elucidate the way in which one culturally significant foundation from Denmark has reflected on - and legitimated - its work and investments at critical moments in the past decades. The paper indicates a foundation with a high degree of reflection on the wider societal...
Full Text Available What lessons can political science classes borrow from the humanities? This paper presents the results of a multi-year study on teaching about Asia as part of a general education program. Given the challenges of meeting common learning outcomes while also teaching discipline-specific lessons, political science courses often underperformed in assessments when compared to benchmark expectations. While our initial conclusion—that a greater focus on multimodal assignments would promote deeper learning and reflection—proved unfounded, explicitly emphasizing students’ reflection on their own process of democratic engagement, in comparison to that of their counterparts in Asia, did seem to address the shortcomings of the previous approaches by giving students context and guidance in their understanding of how democracy works at home and abroad. Data from reflective essays, collected over two years, provide evidence for this finding.
Vartanian, Oshin; Beatty, Erin; Smith, Ingrid
problems were associated with greater activation in the ACC—a key region for conflict detection—even in cases when participants responded stereotypically. In participants with higher CRT scores, conflict problems were associated with greater activation in the posterior cingulate cortex (PCC...
Lemaster, E. W. (Principal Investigator); Chance, J. E.
Data are presented from field measurements of 1980 including 5 acquisitions of handheld radiometer reflectance measurements, 7 complete sets of parameters for implementing the Suits mode, and other biophysical parameters to characterize the soybean canopy. LANDSAT calculations on the simulated Brazilian soybean reflectance are included along with data collected during the summer and fall on 1981 on soybean single leaf optical parameters for three irrigation treatments. Tests of the Suits vegetative canopy reflectance model for the full hemisphere of observer directions as well as the nadir direction show moderate agreement for the visible channels of the MSS and poor agreement in the near infrared channel. Temporal changes in the spectral characteristics of the single leaves were seen to occur as a function of maturity which demonstrates that the absorptance of a soybean single leaf is more a function of thetransmittancee characteristics than the seasonally consistent single leaf reflectance.
Dickson, William S.
A new method is presented for estimating the reflection of a random, multi-directional sea from a coastal structure. The technique is applicable to an array of wave gauges of arbitrary geometry deployed seaward of the reflector. An expansion for small oblique wave incidence angles is used to derive an approximate relationship between measured array cross-spectra and a small number of parameters that describe the incident wave properties and the reflectivity of the structure. Model tests with ...
Slovick, Brian A., E-mail: firstname.lastname@example.org; Baker, John M.; Flom, Zachary; Krishnamurthy, Srini [Applied Optics Laboratory, SRI International, Menlo Park, California 94025 (United States)
We develop an analytical model for calculating the diffuse reflectance of inhomogeneous films containing aligned microplatelets with diameters much greater than the wavelength. The scattering parameters are derived by modeling the platelets as one-dimensional thin films, and the overall diffuse reflectance of the slab is calculated using the Kubelka-Munk model. Our model predicts that reflection minima and maxima arising from coherent interference within the platelets are preserved in the diffuse reflectance of the disordered slab. Experimental validation of the model is provided by reflectance measurements (0.3–15 μm) of a solid aerosol film of aligned hexagonal boron nitride platelets.
Waché, Rémi; Florescu, Marian; Sweeney, Stephen J.; Clowes, Steven K.
We investigate the possibility to selectively reflect certain wavelengths while maintaining the optical properties on other spectral ranges. This is of particular interest for transparent materials, which for specific applications may require high reflectivity at pre-determined frequencies. Although there exist currently techniques such as coatings to produce selective reflection, this work focuses on new approaches for mass production of polyethylene sheets which incorporate either additives or surface patterning for selective reflection between 8 to 13 μ m. Typical additives used to produce a greenhouse effect in plastics include particles such as clays, silica or hydroxide materials. However, the absorption of thermal radiation is less efficient than the decrease of emissivity as it can be compared with the inclusion of Lambertian materials. Photonic band gap engineering by the periodic structuring of metamaterials is known in nature for producing the vivid bright colors in certain organisms via strong wavelength-selective reflection. Research to artificially engineer such structures has mainly focused on wavelengths in the visible and near infrared. However few studies to date have been carried out to investigate the properties of metastructures in the mid infrared range even though the patterning of microstructure is easier to achieve. We present preliminary results on the diffuse reflectivity using FDTD simulations and analyze the technical feasibility of these approaches.
Full Text Available There has been some acknowledgement in the published literature that reflection is a crucial element of the evidence based library and information practice (EBLIP model we have adopted (Booth 2004, 2006; Grant 2007; Helliwell 2007. As we work through a problem and try to incorporate the best available evidence into our decision making, reflection is required at several stages, including the very identification of the problem through to our assessment of the process itself and what we have learned in order to inform future practice. However, reflection and reflective writing have not fully been integrated into the process we espouse, and very little has been done to look more closely at this element of the model and how it can be integrated into professional learning.In a recently published research article, Sen (2010 confirms the relationship between reflection and several aspects of professional practice. These include critical review and decision making, two aspects that are tied closely to the evidence based process. Sen notes: Students were more likely to show evidence of learning, self‐development, the ability to review issues crucially, awareness of their own mental functions, ability to make decision [sic] and being empowered when they had mastered the art of reflective practice and the more deeply analytical reflective writing. (p.84 EBLIP (the journal tries to incorporate elements of reflection within the articles we publish. While we clearly believe in the need for our profession to do quality research and publish that research so that it can be accessible to practitioners, we also know that research cannot be looked at in isolation. Our evidence summaries are one way of reflecting critically on previously published research, and in the same vein, our classics bring older research studies back to the foreground. This work needs to continue to be discussed and looked at for its impact on our profession.More directly, the Using
Weiner, Alan S.; Berzonsky, Michael D.
Selective attention was assessed in second, fourth, and sixth grade reflective and impulsive children with an incidental learning task using pictures (animal-household object pairs) or shapes (colored forms) as stimuli. By the sixth grade, reflective children displayed less incidental learning and greater central learning than impulsive children…
Alina Beatrice Cheşcă
Full Text Available The paper “Creation, Identity and Reflection” approaches the identification in the “mirror” of reality with creation, in other words seeking the authors’ identity in the reflected images. Reflection means attempting to find oneself, the mirror being the main principle of creation. Many characters become interesting only when they step into the world beyond the mirror, when their faces are doubled by the other self or when their selves are returned by other characters. The narcissistic concept of the mirror, i.e. the reflection in the mirror and the representation of the mirror itself, is a recurrent one in literature, but the reflection of the self which is not the self (as it is a reflection does not necessarily appear in a mirror or in a photograph or portrait. Sometimes, the not-self is returned to the self by another person or character. As far as Oscar Wilde’s theories are concerned, the main idea is that people are interesting for their masks, not for their inner nature. What Wilde calls “inner nature” is the characters’ un-reflected self and the mask is the reflection, the self in the mirror. Some characters’ relationships develop within a fiction that they dramatically try to preserve and protect with the risk of suffering. They refuse to take off the masks which define them in the others’ minds and hearts; the narcissistic individuals (both artists and characters seek and love their own image which they project upon facts, thus creating a fictive realm.
Desfechos clínicos do tratamento de tuberculose utilizando o esquema básico recomendado pelo Ministério da Saúde do Brasil com comprimidos em dose fixa combinada na região metropolitana de Goiânia Clinical treatment outcomes of tuberculosis treated with the basic regimen recommended by the Brazilian National Ministry of Health using fixed-dose combination tablets in the greater metropolitan area of Goiânia, Brazil
Anna Carolina Galvão Ferreira
Full Text Available OBJETIVO: Descrever as taxas de cura, falência e abandono do tratamento da tuberculose com o esquema básico preconizado pelo Ministério da Saúde (tratamento com rifampicina, isoniazida, pirazinamida e etambutol por dois meses seguido de isoniazida e rifampicina por quatro meses utilizando comprimidos em dose fixa combinada em regime autoadministrado e descrever os eventos adversos e seus possíveis impactos nos desfechos do tratamento. MÉTODOS: Estudo descritivo utilizando dados coletados prospectivamente dos prontuários médicos de pacientes com tuberculose (idade > 18 anos tratados com o esquema básico em duas unidades básicas de saúde da região metropolitana de Goiânia, GO. RESULTADOS: A amostra foi composta por 40 pacientes com tuberculose. A taxa de cura foi de 67,5%, a taxa de abandono foi de 17,5%, e não ocorreram casos de falência. Nessa amostra, 19 pacientes (47% relataram reações adversas aos medicamentos. Essas foram leves e moderadas, respectivamente, em 87% e 13% dos casos. Em nenhum caso houve necessidade de mudança do esquema ou suspensão do tratamento. CONCLUSÕES: A taxa de cura do esquema básico com o uso de comprimidos em dose fixa combinada sob regime autoadministrado foi semelhante às taxas históricas do esquema anterior. A taxa de abandono, na amostra estudada, foi muito acima da taxa preconizada como adequada (até 5%.OBJECTIVE: To describe the rates of cure, treatment failure, and treatment abandonment obtained with the basic regimen recommended by the Brazilian National Ministry of Health (rifampin, isoniazid, pyrazinamide, and ethambutol for two months, followed by isoniazid and rifampin for four months involving the use of fixed-dose combination tablets (self-administered treatment, as well as to describe adverse events and their potential impact on treatment outcomes. METHODS: This was a descriptive study based on prospective data obtained from the medical records of tuberculosis patients (> 18
Bayley, Cheryl Ann
Often students and educators view assessments as an obligation and finality for a unit. In the current climate of high-stakes testing and accountability, the balance of time, resources and emphasis on students' scores related to assessment have been slanted considerably toward the summative side. This tension between assessment for accountability and assessment to inform teaching strains instruction and educators' ability to use that information to design learning opportunities that help students develop deeper conceptual understanding. A substantive body of research indicates that formative and reflective assessment can significantly improve student learning. Biology Reflective Assessment Curriculum (BRAC) examines support provided for high school science students through assessment practices. This investigation incorporates the usage of reflective assessments as a guiding practice for differentiated instruction and student choice. Reflective assessment is a metacognitive strategy that promotes self-monitoring and evaluation. The goals of the curriculum are to promote self-efficacy and conceptual understanding in students learning biology through developing their metacognitive awareness. BRAC was implemented in a high school biology classroom. Data from assessments, metacognitive surveys, self-efficacy surveys, reflective journals, student work, a culminating task and field notes were used to evaluate the effectiveness of the curriculum. The results suggest that students who develop their metacognitive skills developed a deeper conceptual understanding and improved feelings of self-efficacy when they were engaged in a reflective assessment unit embedded with student choice. BRAC is a tool for teachers to use assessments to assist students in becoming metacognitive and to guide student choice in learning opportunities.
Cui, Liwang; Yan, Guiyun; Sattabongkot, Jetsumon; Cao, Yaming; Chen, Bin; Chen, Xiaoguang; Fan, Qi; Fang, Qiang; Jongwutiwes, Somchai; Parker, Daniel; Sirichaisinthop, Jeeraphat; Kyaw, Myat Phone; Su, Xin-zhuan; Yang, Henglin; Yang, Zhaoqing; Wang, Baomin; Xu, Jianwei; Zheng, Bin; Zhong, Daibin; Zhou, Guofa
The Greater Mekong Subregion (GMS), comprised of six countries including Cambodia, China's Yunnan Province, Lao PDR, Myanmar (Burma), Thailand and Vietnam, is one of the most threatening foci of malaria. Since the initiation of the WHO's Mekong Malaria Program a decade ago, malaria situation in the GMS has greatly improved, reflected in the continuous decline in annual malaria incidence and deaths. However, as many nations are moving towards malaria elimination, the GMS nations still face great challenges. Malaria epidemiology in this region exhibits enormous geographical heterogeneity with Myanmar and Cambodia remaining high-burden countries. Within each country, malaria distribution is also patchy, exemplified by ‘border malaria’ and ‘forest malaria’ with high transmission occurring along international borders and in forests or forest fringes, respectively. ‘Border malaria’ is extremely difficult to monitor, and frequent malaria introductions by migratory human populations constitute a major threat to neighboring, malaria-eliminating countries. Therefore, coordination between neighboring countries is essential for malaria elimination from the entire region. In addition to these operational difficulties, malaria control in the GMS also encounters several technological challenges. Contemporary malaria control measures rely heavily on effective chemotherapy and insecticide control of vector mosquitoes. However, the spread of multidrug resistance and potential emergence of artemisinin resistance in Plasmodium falciparum make resistance management a high priority in the GMS. This situation is further worsened by the circulation of counterfeit and substandard artemisinin-related drugs. In most endemic areas of the GMS, P. falciparum and P. vivax coexist, and in recent malaria control history, P. vivax has demonstrated remarkable resilience to control measures. Deployment of the only registered drug (primaquine) for the radical cure of vivax malaria is
Reflecting has a double meaning, mirroring and thinking. The seminar will investigate how these two meanings intervene in each other. As we perceive we are already in pre-refectory state, and thinking involves a lot of not only thoughts, but also of senses and sensing, wherefrom our thoughts star...
In my youth, I was a worshipper of Mao Zedong. From the latter stage of the Mao Era to the early years of Reform and Opening, I began to reflect on Mao and the Communist Revolution he launched. In recent years I’ve devoted myself to empirical historical research on Mao, seeking the truth about Mao and China’s modern history.
Burcharth, H. F.; Larsen, Brian Juul
The investigation concerns the design of a new internal breakwater in the main port of Ibiza. The objective of the model tests was in the first hand to optimize the cross section to make the wave reflection low enough to ensure that unacceptable wave agitation will not occur in the port. Secondly...
Eklund, S.; Mandel, H.; Teller, E.
Personal reflections after twenty one years of nuclear power are presented by a number of those who were international figures in the nuclear energy field during that period. Lessons learnt, achievements, prospects and predictions for the future are discussed in eleven brief surveys. (U.K.)
Greenslade, Thomas B.
Students all know that reflection from a plane mirror produces an image that is reversed right to left and so cannot be read by anyone but Leonardo da Vinci, who kept his notes in mirror writing. A useful counter-example is the Porro prism, which produces an image that is not reversed.
Wistoft, Karen; Nordentoft, Helle Merete
This article examines the impact of a value-reflected approach in health education by demonstrating the nature of professional competence development connected to this approach. It is based on findings from two three-year health educational development projects carried out by school health nurses...... develop pedagogical competences in health education improving school childrens’ health....
This article compares how Members of Parliament in the United Kingdom and Ireland reflect on constituency service as an aspect of political representation. It differs from existing research on the constituency role of MPs in two regards. First, it approaches the question from a sociological viewp...
Williams, Kimberley Buster
The author has been blessed with great mentors throughout her career. When she was invited to participate in the Leadership University of Mary Washington (UMW), a mentoring program at her institution, she did not hesitate to say yes. In this article, the author shares her reflections on mentoring.
Sciammarella, Cesar A.; Combell, Olivier
A new reflection moire technique is introduced in this paper. The basic equations that relate the measurement of slopes to the basic geometric and optical parameters of the system are derived. The sensitivity and accuracy of the method are discussed. Examples of application to the study of silicon wafers and electronic chips are given.
This paper reflects on the development or robots, both their physical shape as well as their intelligence. The later strongly depends on the progress made in the artificial intelligence (AI) community which does not yet provide the models and tools necessary to create intelligent robots. It is time
The author was recently asked to reflect on her "educational journey." As far as she can remember she has been hungry to learn. A friend once described her as having "hambres atrasadas," which he described as a kind of "hunger nipping at her heels." It goes back, of course, to her parents: Her father's and her early…
The following reflections relate to the reasons for and an approach to an autobiographic task, the notions that underpin it, and some thoughts about the quality and value of such a project. The focus was on the ways one views curriculum change over time; and the intention was to provide an example that others may sense as either familiar or at…
Kauffman, James M.
Reflections on the field of special education offer six ideas: (1) the value of science; (2) the continuing value of separate and special education for some students; (3) the continuing importance of prevention; (4) the importance of academic instruction; (5) the importance of social justice for the poor; and (6) a renewed emphasis on human…
George Knox reflects on his 15-year career as president of Labette Community College in Parsons, Kansas. Knox writes that, as a first-time president coming into a brand new system, he was very fortunate to have many seasoned presidents and mentors in Kansas and from the American Association of Community Colleges' (AACC) Presidents Academy. He says…
Greater confinement disposal (GCO) has been defined by the National Low-Level Waste Program as the disposal of low-level waste in such a manner as to provide greater containment of radiation, reduce potential for migration or dispersion or radionuclides, and provide greater protection from inadvertent human and biological intrusions in order to protect the public health and safety. This paper discusses: the need for GCD; definition of GCD; advantages and disadvantages of GCD; relative dose impacts of GCD versus shallow land disposal; types of waste compatible with GCD; objectives of GCD borehole demonstration test; engineering and technical issues; and factors affecting performance of the greater confinement disposal facility
<正>Introduction According to Pollard and Triggs(1997),reflective teaching is a process through which the capacity to make such professional judgments can be developed and maintained.Then what is a reflective teacher?Reflective teacher is someone who reflects systematically on her practice in a constant attempt to improve
Geach, Nicole; Moghaddam, Nima G; De Boos, Danielle
Team formulation is promoted by professional practice guidelines for clinical psychologists. However, it is unclear whether team formulation is understood/implemented in consistent ways - or whether there is outcome evidence to support the promotion of this practice. This systematic review aimed to (1) synthesize how team formulation practice is defined and implemented by practitioner psychologists and (2) analyse the range of team formulation outcomes in the peer-reviewed literature. Seven electronic bibliographic databases were searched in June 2016. Eleven articles met inclusion criteria and were quality assessed. Extracted data were synthesized using content analysis. Descriptions of team formulation revealed three main forms of instantiation: (1) a structured, consultation approach; (2) semi-structured, reflective practice meetings; and (3) unstructured/informal sharing of ideas through routine interactions. Outcome evidence linked team formulation to a range of outcomes for staff teams and service users, including some negative outcomes. Quality appraisal identified significant issues with evaluation methods; such that, overall, outcomes were not well-supported. There is weak evidence to support the claimed beneficial outcomes of team formulation in practice. There is a need for greater specification and standardization of 'team formulation' practices, to enable a clearer understanding of any relationships with outcomes and implications for best-practice implementations. Under the umbrella term of 'team formulation', three types of practice are reported: (1) highly structured consultation; (2) reflective practice meetings; and (3) informal sharing of ideas. Outcomes linked to team formulation, including some negative outcomes, were not well evidenced. Research using robust study designs is required to investigate the process and outcomes of team formulation practice. © 2017 The British Psychological Society.
Vyskocilová, Jana; Prasko, Jan
Theories of ethics and ethical reflection may be applied to both theory and practice in psychotherapy. There is a natural affinity between ethics and psychotherapy. Psychotherapy practice is concerned with human problems, dilemmas and emotions related to both one's own and other people's values. Ethics is also concerned with dilemmas in human thinking and with how these dilemmas reflect other individuals' values. Philosophical reflection itself is not a sufficient basis for the ethics of psychotherapy but it may aid in exploring attitudes related to psychotherapy, psychiatry and health care. PubMed, Web of Science and Scopus databases were searched for articles containing the keywords "psychotherapy", "ethics", "therapeutic relationship" and "supervision". The search was conducted by repeating the terms in various combinations without language or time restrictions. Also included were data from monographs cited in reviews. The resulting text is a review with conclusions concerning ethical aspects of psychotherapy. The ability to behave altruistically, sense for justice and reciprocity and mutual help are likely to be genetically determined as dispositions to be later developed by upbringing or to be formed or deformed by upbringing. Early experiences lead to formation of ethical attitudes which are internalized and then applied to both one's own and other people's behavior. Altruistic behavior has a strong impact on an individual's health and its acceptance may positively influence the pathophysiological mechanisms underlying numerous diseases. Ethical theory and reflection, however, may be applied to both theory and practice of psychotherapy in a conscious, targeted and thoughtful manner. In everyday practice, psychotherapists and organizations must necessarily deal with conscious conflicts between therapeutic possibilities, clients' wishes, their own as well as clients' ideas and the real world. Understanding one's own motives in therapy is one of the aims of a
Illarionova, N.M.; Fuks, M.A.; Ehventov, A.Z.
The paper is concerned with the results of the clinical testing of a combined radionuclide method of assessment of the greater and uteroplacentral circulation in 15 women with plural pregnancy. The method permits the detection of hemodynamic changes without increasing radiation exposure to the mother's body and fetuses, the determination of a type of plural pregnancy (monochorionic or dichorial twins), and the prediction of pregnancy outcome that is very important for the choice of appropriate and timely therapy
We assessed the impacts of human activities on the Greater Akaki River using physicochemical parameters and macroinvertebrate metrics. Physicochemical samples and macroinvertebrates were collected bimonthly from eight sites established on the Greater Akaki River from February 2006 to April 2006. Eleven metrics ...
Bray, Mark; Qin, Gui
The evolution of comparative education in Greater China (mainland China, Taiwan, Hong Kong, and Macau) has been influenced by size, culture, political ideologies, standard of living, and colonialism. Similarities and differences in conceptions of comparative education are identified among the four components and between Greater China and other…
Prevey, Janet; Vellend, Mark; Ruger, Nadja
Warmer temperatures are accelerating the phenology of organisms around the world. Temperature sensitivity of phenology might be greater in colder, higher latitude sites than in warmer regions, in part because small changes in temperature constitute greater relative changes in thermal balance...
to fledging was unknown owing to the rapid drying of the pan in late March 1999. No Greater Flamingo breeding was seen that season. Exceptional flooding during 1999–2000 produced highly favourable breeding conditions, with numbers of Greater and Lesser Flamingos breeding estimated to be 23 869 and 64 287 pairs, ...
Introduction: The knowledge of the anatomy of greater occipital nerve and its relation to occipital artery is important for the surgeon. Blockage or surgical release of greater occipital nerve is clinically effective in reducing or eliminating chronic migraine symptoms. Aim: The aim of this research was to study the anatomy of ...
Nancy Mohamed El Sekily
Aug 19, 2014 ... Abstract Introduction: The knowledge of the anatomy of greater occipital nerve and its relation to occipital artery is important for the surgeon. Blockage or surgical release of greater occipital nerve is clinically effective in reducing or eliminating chronic migraine symptoms. Aim: The aim of this research was to ...
Hudalah, Delik; Viantari, Dimitra; Firman, Tommy; Woltjer, Johan
Industrial land development has become a key feature of urbanization in Greater Jakarta, one of the largest metropolitan areas in Southeast Asia. Following Suharto's market-oriented policy measures in the late 1980s, private developers have dominated the land development projects in Greater Jakarta.
Council for Adult and Experiential Learning (NJ1), 2008
Human capital is one of the critical issues that impacts the Greater Philadelphia region's ability to grow and prosper. The CEO Council for Growth (CEO Council) is committed to ensuring a steady and talented supply of quality workers for this region. "Strategies for Talent Management: Greater Philadelphia Companies in Action" provides…
Butler, Tracy R; O'Mara, Erin M; Wilson, Josephine F
The Valence Hypothesis of cerebral lateralization of emotion suggests greater right hemisphere activation during negative mood and greater left hemisphere activation during positive mood. This can manifest as visual field attentional bias. Here, study participants completed an assessment of current mood state (PANAS) and made a drawing (Drawing 1). To induce positive or negative mood, participants played a game; then, the winner read a script depicting a positive interpersonal interaction and the loser read a script depicting a negative interpersonal interaction. Participants then drew a second picture (Drawing 2) and completed the PANAS. We hypothesized that the game outcome would change current mood state and hemispheric activation, which would be reflected in drawing placement. The placement of Drawing 2 moved right for winners and left for losers. Winners experienced a greater increase in positive affect from Time 1 to Time 2 than losers and had decreased negative affect from Time 1. Losers had decreased positive affect from Time 1 and had a greater increase in negative affect from Time 1 to Time 2 than winners. Our results suggest that change in current mood state may be objectively observed by evaluating hemispatial bias reflective of brain hemispheric activation with drawings. Copyright © 2018 Elsevier Inc. All rights reserved.
This user's guide to the Bragg Reflection Program (BRP) is in the nature of an informal report. The general purpose of BRP is to scan a series of Bragg reflections automatically in order to obtain profiles and integrated intensities. The program is used in conjunction with the SUPERVISOR and READ packages, and the procedures for using it are similar to those for the Triple-Axis Control program. All the general features of the system, SUPERVISOR and READ packages as described in the Spectrometer Control Systems User's Guide are preserved. The presentation assumes that the reader is familiar with these. Sections are given on the READ package, execution and use, error messages, and output. A few sample problems are shown. (1 figure) (U.S.)
with a Software Switch for Active Networks ”. We had initially called the project “ SoftSwitch ”, but after some concerns David Farber raised that this...Reflections on Active Networking Jonathan M. Smith CIS Department, University of Pennsylvania email@example.com Abstract Interactions among...telecommunications networks , computers, and other peripheral devices have been of interest since the earliest distributed computing systems. A key
This is a report of the main points I made in an informal "conversation" with Paul Fletcher and the audience at the 14th ICPLA conference in Cork. The observations arose randomly, as part of an unstructured 1-h Q&A, so they do not provide a systematic account of the subject, but simply reflect the issues which were raised by the conference participants during that time.
Numerical evolution of massless scalar fields on Kerr background is studied. The initial data specifications are chosen to have compact support separated from the ergoregion and to yield nearly monochromatic incident wave packets. The initial data is also tuned to maximize the effect of superradiance. Evidences are shown indicating that instead of the anticipated energy extraction from black hole the incident radiation fail to reach the ergoregion rather it suffers a nearly perfect reflection.
Ozarski, R.G.; Prior, J.
On Shiva the beam energy along the chain is monitored using available reflections and/or transmission through beam steering, splitting, and polarizing optics without the intrusion of any additional glass for diagnostics. On the preamp table the diagnostic signal is obtained from the signal transmitted through turning mirrors. At the input of each chain the signal is obtained from the transmission through one of the mirrors used for the chain input alignment sensor (CHIP). At the chain output the transmission through the final turning mirror is used. These diagnostics have proved stable and reliable. However, one of the prime diagnostic locations is at the output of the beta rod. The energy at this location is measured by collecting small reflections from the last polarizer surface of the beta Pockels cell polarizer package. Unfortunately, calibration of this diagnostic has varied randomly, seldom remaining stable for a week or more. The cause of this fluctuation has been investigated for the past year and'it has been discovered that polarizer reflectivity varies with humidity. This report will deal with the possible causes that were investigated, the evidence that humidity is causing the variation, and the associated mechanism
Andersen, Nina Bjerre
The use of reflection as a learning approach is increasing in medical education, often based on the assumption that students will not reflect without being encouraged to. Personal reflection is used to describe students’ ability to critically reflect on own learning and functioning. The assumption...... here is also that medical students seem not to reflect spontaneously. We explored students’ level of personal reflection and validated a questionnaire that attempt to measure personal reflection. We translated and adapted the Groningen Reflection Ability Scale (GRAS) to use in a Danish context...... ‘reflective’ outcomes of educational interventions....
Through the regular use of what Donald Schon has termed reflection-in-action and reflection-on-action, students can learn to improve their "reflection-in-presentation," in Kathleen Blake Yancey's term. Students are often asked to do this type of reflection-in-presentation as a capstone to first-year or basic writing courses. However, a number of…
Pappas, Marjorie L.
In this article, the author discusses how reflection can be used as self-assessment. Reflection involves not only thinking about a learning experience, but also questioning parts of the experience. Reflection is thinking about what one knows from the learning experience, what one might do differently the next time. Reflection is wondering about…
Hoogedoorn, L.; Gerritsen, M.J.P.; Wolberink, E.A.W.; Peppelman, M.; Kerkhof, P.C.M. van de; Erp, P.E.J. van
BACKGROUND: Reflectance confocal microscopy (RCM) is gradually implemented in dermatology. Strategies for further implementation and practical 'hands on' guidelines are lacking. OBJECTIVE: The primary outcome was to conduct a general strategy for further implementation of RCM. The secondary outcome
Lauring, Jakob; Selmer, Jan
We investigated 640 self-initiated expatriate academics residing in Greater China. We examined whether their inherent demographic characteristics (age/gender) and acquired demographic characteristics (marital status/seniority) differentiated their work outcomes regarding job adjustment, time...... to proficiency, performance and satisfaction. We also explored the associations between global mobility orientation and these four work outcomes and examined to what extent the demographic characteristics differentiated the relationships. Results support most hypothesized differences. We found that a global...... mobility orientation was associated with all the work outcomes, except satisfaction. For inherent demographic characteristics, we found support for our hypotheses that for individuals with less successful demographics (younger, male), there was a stronger relationship between global mobility orientation...
Wapenaar, Kees; van der Neut, Joost; Thorbecke, Jan; Broggini, Filippo; Slob, Evert; Snieder, Roel
Imaging of seismic reflection data is usually based on the assumption that the seismic response consists of primary reflections only. Multiple reflections, i.e. waves that have reflected more than once, are treated as primaries and are imaged at wrong positions. There are two classes of multiple reflections, which we will call surface-related multiples and internal multiples. Surface-related multiples are those multiples that contain at least one reflection at the earth's surface, whereas internal multiples consist of waves that have reflected only at subsurface interfaces. Surface-related multiples are the strongest, but also relatively easy to deal with because the reflecting boundary (the earth's surface) is known. Internal multiples constitute a much more difficult problem for seismic imaging, because the positions and properties of the reflecting interfaces are not known. We are developing reflection imaging methodology which deals with internal multiples. Starting with the Marchenko equation for 1D inverse scattering problems, we derived 3D Marchenko-type equations, which relate reflection data at the surface to Green's functions between virtual sources anywhere in the subsurface and receivers at the surface. Based on these equations, we derived an iterative scheme by which these Green's functions can be retrieved from the reflection data at the surface. This iterative scheme requires an estimate of the direct wave of the Green's functions in a background medium. Note that this is precisely the same information that is also required by standard reflection imaging schemes. However, unlike in standard imaging, our iterative Marchenko scheme retrieves the multiple reflections of the Green's functions from the reflection data at the surface. For this, no knowledge of the positions and properties of the reflecting interfaces is required. Once the full Green's functions are retrieved, reflection imaging can be carried out by which the primaries and multiples are
... reorganized its command and control structure. This regulation revision reflects the current organizational structure and is aligned with water management activities during recent flood and drought events in the... inter- divisional coordination of water management activities within the Greater Mississippi River Basin...
Miettinen, Olli S
Having thought much about medicine in my career-long effort to understand it and the research for its advancement, I have come to views rather different form the now-prevailing ones in respect to what preventive medicine is about; what epidemiology is in relation to preventive medicine; what distinguishes preventive medicine in preventive healthcare at large; the relation of preventive medicine to public health; the concept of health promotion; and also the core principles of preventive medicine. All of these views I set forth in this article, for the readers' critical reflection. Copyright © 2014 Elsevier Inc. All rights reserved.
Prey selection by a reintroduced lion population in the Greater Makalali Conservancy, South Africa. Dave Druce, Heleen Genis, Jonathan Braak, Sophie Greatwood, Audrey Delsink, Ross Kettles, Luke Hunter, Rob Slotow ...
Full Text Available Livelihoods and Biodiversity in Developing Countries Case study area: Greater Kruger, South Africa January 2011 Kolhapur, India Where are we? HARDSHIP LIVELIHOODS NATURE & BIODIVERSITY BELIEFS & CULTURAL PRACTISE threesansinv foursansinv onesansinv...
GLA Building/City Hall) ... Journal Home > Vol 11, No 2 (2007) > ... The Greater London Authority building was acclaimed as being energy efficient, with claims of 75 % reduction in its annual energy consumption compared to a high specification ...
Oyler-McCance, Sara J.; Quinn, Thomas W.
Recent research on Greater Sage-Grouse (Centrocercus urophasianus) genetics has revealed some important findings. First, multiple paternity in broods is more prevalent than previously thought, and leks do not comprise kin groups. Second, the Greater Sage-Grouse is genetically distinct from the congeneric Gunnison sage-grouse (C. minimus). Third, the Lyon-Mono population in the Mono Basin, spanning the border between Nevada and California, has unique genetic characteristics. Fourth, the previous delineation of western (C. u. phaios) and eastern Greater Sage-Grouse (C. u. urophasianus) is not supported genetically. Fifth, two isolated populations in Washington show indications that genetic diversity has been lost due to population declines and isolation. This chapter examines the use of molecular genetics to understand the biology of Greater Sage-Grouse for the conservation and management of this species and put it into the context of avian ecology based on selected molecular studies.
Ma, Truong; Kornbau, Craig
Abstract Venous aneurysms often present as painful masses. They can present either in the deep or superficial venous system. Deep venous system aneurysms have a greater risk of thromboembolism. Though rare, there have been case reports of superficial aneurysms and thrombus causing significant morbidity such as pulmonary embolism. We present a case of an anomalous greater saphenous vein connection with an aneurysm and thrombus resulting in a pulmonary embolism. This is the only reported case o...
Full Text Available The review analyzes the structure organization and pathophysiological age specificities of the greater omentum, which determine its uniqueness and functional diversity in a child's organism. the article discusses protective functions of the organ, its role in the development of post operative complications of children, and the usage in children's reconstructive plastic surgery.Key words: greater omentum, omentitis, of post operative complications, children.
Kok, J; Chabeli, M M
According to the outcomes-based education and training system of education (OBET) in the country and the South African Nursing Council, education should focus on "creating" reflective learners and practitioners. This article seeks to determine the effectiveness of reflective journal writing in promoting the reflective thinking of learners in clinical nursing education and to validate the guidelines described in a bigger study on how to facilitate reflective thinking using reflective journal writing. A qualitative, contextual, explorative, descriptive research design was used to determine the learners' perceptions on whether reflective journal writing did promote their higher-level thinking skills during the six-month placement in a psychiatric clinical practice using the reflective diaries. From a population of seventeen fourth-year students, six volunteered to participate in a focus group interview. The data was analysed by means of the descriptive method of open coding of Tesch (in Creswell, 1994:154-156). Positive and negative results from the perceptions of the participants and a literature review served as a basis for deducing and describing guidelines for the effective use of reflective journal writing in promoting reflective thinking in clinical nursing education. The positive perception was the development of problem-solving skills attained through reflection by using analytical critical thinking, synthesis and the evaluation of situations. Self-evaluation leading to intellectual growth and self-awareness indicated a positive perception. Negative perceptions were that reflective journal writing is time consuming, content based with a lack of clear expectations from the teacher, and distrust of students about the information written. Guba's model of ensuring trustworthiness in qualitative research as described in Krefting (1991:215-222) was employed. It is concluded that reflective journal writing in clinical nursing education does promote reflective
Bianconi, A.; Cristiano, A.; Leali, M.; Lodi Rizzini, E.; Venturelli, L.; Zurlo, N.
It is common belief that the interaction between antimatter and ordinary solid matter is dominated by annihilation. However, non-destructive processes may play a relevant role too. One century ago E. Rutherford wrote about the "diffuse reflection" of alpha and beta particles by thin layers of different metals: "The observations ... of Geiger and Marsden on the scattering of alpha rays indicate that some of the alpha particles must suffer a deflexion of more than a right angle at a single encounter.... It will be shown that the main deductions from the theory are independent of whether the central charge is supposed to be positive or negative". Although the theory of electromagnetic scattering is in first approximation independent of the relative sign of the colliding particles, in the case where projectile antiprotons are shot against a wall of solid matter the Rutherford diffuse reflection mechanism competes with the annihilation process. So it is not obvious at all that a relevant part of an antiproton beam...
This invited paper advances a framing context for considering next steps in HOF and organizational culture in light of the presentations and discussions that occur during the conference. Many of the contributions during the conference will represent results of scholarly research, structured investigations, or formal organizational improvement efforts. This contribution is intended as informal reflection by a 40-year nuclear veteran on themes from other presentations considering questions such as: ''Where do we think we are?, Are we better off as an industry based on what we have done?, Where do we think we need to go?, What do we think we need to do?, and, Why do we think these things?'' Our coming together on this occasion marks 30 years since the publication of INSAG-l. As we reflect on the past, perhaps it is time to pose a series of questions. Are we sustainers of a mature technology that is in some places declining and being replaced by other energy sources? If we consider nuclear a mature technology, should we focus most on operational excellence with renewed attention to managing the unexpected? Or, is innovation still a vital part of our industry?
Niraj, G; Critchley, Peter; Kodivalasa, Mahesh; Dorgham, Mohammed
Clinical presentation of spontaneous intracranial hypotension headache (SIHH) has similarities with postdural puncture headache (PDPH). Recommended treatment for both conditions is an epidural blood patch. Successful outcomes following greater occipital nerve blocks have been reported in the management of PDPH. We present the first report of greater occipital nerve treatment in SIHH. A 40-year-old male presented with a 2-year history of daily postural headaches having a significant impact on quality of life. Magnetic resonance imaging revealed bilateral convexity subdural collections. Post gadolinium scan revealed pachymeningeal enhancement with reduced pontomesencephalic angle below 50 degrees. The patient was offered an epidural blood patch and greater occipital nerve block with corticosteroids. The patient chose occipital nerve block. The patient reported significant short-term benefit lasting 4 months. Thereafter, the patient underwent pulsed radiofrequency treatment to bilateral greater occipital nerves. He reported significant benefit lasting 10 months. Greater occipital nerve treatment may have a role in management of SIHH. © 2017 American Headache Society.
Full Text Available Background: To understand the characteristics, ophthalmic outcomes, and risk factors of retinopathy of prematurity (ROP in patients with birth weight (BW greater than 1500 g. The applicability of the ROP screening criteria to the Taiwanese population was also examined. Methods: The study included 104 eyes from 54 ROP patients who had BW greater than 1500 g from 1981 to 2008. Demographic information, disease courses, ophthalmic outcomes, and possible systemic risk factors were recorded. The infants were divided into groups of mild and severe ROP for a risk factor analysis. Results: The mean gestational age (GA of the infants was 31 ± 1.3 weeks, and the mean BW was 1675 ± 249 g. Mild ROP regressed in 94 eyes (90%, and 10 eyes (10% developed severe ROP. After various treatments, the regression rates for prethreshold or threshold ROP (n = 8 and stage 4 ROP (n = 2 were 100% and 50%, respectively. Forty-eight patients (85% had at least three associated systemic risk factors. A multiple logistic regression analysis revealed that patients with an intraventricular hemorrhage were found to have an increased chance of developing severe ROP, especially those with BW greater than 1500 g (p = 0.015. There was also a significant association between patients who had severe ROP and an increased risk of having cerebral palsy (CP at 1.5 years of age (p = 0.013. Conclusion: The majority of patients with BW greater than 1500 g developed mild ROP. However, advanced ROP with poor visual outcome was also encountered in some patients.
Baril, Yannick; Bourgeois, Yan; Brailovski, Vladimir; Duke, Kajsa; Laflamme, G Yves; Petit, Yvan
Cable-grip systems are commonly used for greater trochanteric reattachment because they have provided the best fixation performance to date, even though they have a rather high complication rate. A novel reattachment system is proposed with the aim of improving fixation stability. It consists of a Y-shaped fixation plate combined with locking screws and superelastic cables to reduce cable loosening and limit greater trochanter movement. The novel system is compared with a commercially available reattachment system in terms of greater trochanter movement and cable tensions under different greater trochanteric abductor application angles. A factorial design of experiments was used including four independent variables: plate system, cable type, abductor application angle, and femur model. The test procedure included 50 cycles of simultaneous application of an abductor force on the greater trochanter and a hip force on the femoral head. The novel plate reduces the movements of a greater trochanter fragment within a single loading cycle up to 26%. Permanent degradation of the fixation (accumulated movement based on 50-cycle testing) is reduced up to 46%. The use of superelastic cables reduces tension loosening up to 24%. However this last improvement did not result in a significant reduction of the grater trochanter movement. The novel plate and cables present advantages over the commercially available greater trochanter reattachment system. The plate reduces movements generated by the hip abductor. The superelastic cables reduce cable loosening during cycling. Both of these positive effects could decrease the risks related to grater trochanter non-union. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.
Cox, Timothy; Lekner, John
Exact closed-form solutions of the time-dependent Schrodinger equation are obtained, describing the propagation of wavepackets in the neighbourhood of a potential. Examples given include zero reflection, total reflection and partial reflection of the wavepacket, for the sech[superscript 2]x/a, 1/x[superscript 2] and delta(x) potentials,…
Full Text Available Repeated stress can trigger a range of psychiatric disorders, including anxiety. The propensity to develop abnormal behaviors after repeated stress is related to the severity, frequency and number of stressors. However, the pattern of stress exposure may contribute to the impact of stress. In addition, the anxiogenic nature of repeated stress exposure can be moderated by the degree of coping that occurs, and can be reflected in homotypic habituation to the repeated stress. However, expectations are not clear when a pattern of stress presentation is utilized that diminishes habituation. The purpose of these experiments is to test whether interrupted stress exposure decreases homotypic habituation and leads to greater effects on anxiety-like behavior in adult male rats. We found that repeated interrupted restraint stress resulted in less overall homotypic habituation compared to repeated daily restraint stress. This was demonstrated by greater production of fecal boli and greater corticosterone response to restraint. Furthermore, interrupted restraint stress resulted in a lower body weight and greater adrenal gland weight than daily restraint stress, and greater anxiety-like behavior in the elevated plus maze. Control experiments demonstrated that these effects of the interrupted pattern could not be explained by differences in the total number of stress exposures, differences in the total number of days that the stress periods encompased, nor could it be explained as a result of only the stress exposures after an interruption from stress. These experiments demonstrate that the pattern of stress exposure is a significant determinant of the effects of repeated stress, and that interrupted stress exposure that decreases habituation can have larger effects than a greater number of daily stress exposures. Differences in the pattern of stress exposure are therefore an important factor to consider when predicting the severity of the effects of repeated
Quinn, G.; Grant, P.; Winberg, M.; Williams, K.
This report estimates packaging factors for several waste types that are potential greater-than-Class C (GTCC) low-level radioactive waste (LLW). The packaging factor is defined as the volume of a GTCC LLW disposal container divided by the as-generated or ''unpackaged'' volume of the waste loaded into the disposal container. Packaging factors reflect any processes that reduce or increase an original unpackaged volume of GTCC LLW, the volume inside a waste container not occupied by the waste, and the volume of the waste container itself. Three values are developed that represent (a) the base case or most likely value for a packaging factor, (b) a high case packaging factor that corresponds to the largest anticipated disposal volume of waste, and (c) a low case packaging factor for the smallest volume expected. GTCC LLW is placed in three categories for evaluation in this report: activated metals, sealed sources, and all other waste
In recent years, design research has been the object of growing attention in universities and academies throughout the world. The present paper addresses the heterogeneous character of design research and the current need for reflection on the various approaches and interests. For this purpose......, the paper follows two steps. First, it proposes a categorization of the field in the form of a position model. The paper’s underlying assumption is that design research as a discipline exists in many different forms that cannot necessarily be brought together under one common academic research tradition......; instead it is necessary to attempt to define the field in order to initiate discussions about what constitutes the various research bases for design. Second, the paper discusses the implication for future design research when it is an interdisciplinary field that involves many disciplines, mindsets...
In recent years, a focus on inclusion and vulnerable children has reignited discussions about the quality of pedagogical work. It has also initiated processes of change that have challenged the Danish kindergarten tradition and the identity of the pedagogue in a number of different ways. In this ......In recent years, a focus on inclusion and vulnerable children has reignited discussions about the quality of pedagogical work. It has also initiated processes of change that have challenged the Danish kindergarten tradition and the identity of the pedagogue in a number of different ways...... in which the practical sense and tacit knowledge are related to questions of power and social actors’ strategies for positioning themselves within a social space. This demands a particular focus on the historical effect of the concept of ‘the reflective practitioner’ as a symbolic marker of identity...
The SLAP data bases represent a major step forward in the reliability analysis of passive components. The present reflections are motivated by draft documentation for SLAP and have profited greatly from discussions with the SLAP team. We collect a number of remarks and suggestions: The use of event and failure fields to organize the data seems sensible and feasible, from a data analysis viewpoint. Influence factors, i. e. environmental influences which are affected by plant operations, are clearly important yet very difficult to accommodate in any straightforward data analysis methodology. We would welcome a serious effort to estimate the exposure in the various exposure cells. These estimates would not be based on failure records, but on knowledge of plant design and operations. Quantitative expert judgement might be a viable alternative to a massive review of all plants in the SLAP data base
We use modular invariance and crossing symmetry of conformal field theory to reveal approximate reflection symmetries in the spectral decompositions of the partition function in two dimensions in the limit of large central charge and of the four-point function in any dimension in the limit of large scaling dimensions Δ0 of external operators. We use these symmetries to motivate universal upper bounds on the spectrum and the operator product expansion coefficients, which we then derive by independent techniques. Some of the bounds for four-point functions are valid for finite Δ0 as well as for large Δ0. We discuss a similar symmetry in a large spacetime dimension limit. Finally, we comment on the analogue of the Cardy formula and sparse light spectrum condition for the four-point function. (based on 1510.08772 with Kim & Ooguri). This seminar will be given via videolink
Full Text Available As academics we study, research and teach audiovisual media, yet rarely disseminate and mediate through it. Today, developments in production technologies have enabled academic researchers to create videos and mediate audiovisually. In academia it is taken for granted that everyone can write a text. Is it now time to assume that everyone can make a video essay? Using the online journal of academic videos Audiovisual Thinking and the videos published in it as a case study, this article seeks to reflect on the emergence and legacy of academic audiovisual dissemination. Anchoring academic video and audiovisual dissemination of knowledge in two critical traditions, documentary theory and semiotics, we will argue that academic video is in fact already present in a variety of academic disciplines, and that academic audiovisual essays are bringing trends and developments that have long been part of academic discourse to their logical conclusion.
Full Text Available The Feature for this issue Reflections on Student Persistence has been prepared by Professor Vincent Tinto, Distinguished University Professor Emeritus at Syracuse University, United States of America (USA and a longtime friend and supporter of STARS. Vincent explores the case for motivation to be considered as a significant aspect of the tertiary student psyche by drawing on theoretical frameworks, research and practical experiences related to the issue. He synthesises this extensive, detailed, rich but often somewhat impenetrable data into a trilogy of clear and credible key dimensions of the motivation construct student self efficacy, sense of belonging and perceived value of the curriculum. This interpretation of the literature is a personal but informed reflection and is a timely piece which highlights the breadth and profundity of the presentations at this year's conference in Adelaide, Australia where students in all their diversity are central to our focus on enhancing the student experience. In this opening article, Vincent refers directly to the STARS papers selected for this Conference issue of the Journal which also address the importance of student persistence, self-efficacy and building the sense of belonging within their own institutional communities (Fernandes, Ford, Rayner & Pretorius; Kahu, Nelson, & Picton; McFarlane, Spes-Skrbis & Taib; Naylor; Smallhorn. Echoing his position on social justice and his advocacy for underserved students, Vincent reminds us that educational equity gaps still exist, and he encourages us to see the issue of persistence through the eyes of the students to support their perseverance and completion and thereby help reduce educational disadvantage.
Full Text Available Studies on reflective practice in teacher education are increasingly getting more attention at least in the last 2 decades. This article discusses concepts of reflection and how it is implemented in educating pre-service teachers on their early stage of professional learning. The purposes of doing the reflection for pre-service teachers are not only for illuminating their professional learning experiences, but also to critically reflect their vocation as teachers, including the values which may be dictated to them through rigid regulations. Reflection in teacher education is crucial as it connects well with learning in that learners use reflection to exercise their mind and to evaluate their learning experiences. Besides, this article also highlights some perceived difficulties to implement reflective practice, as well as ways how to promote reflection. DOI: https://doi.org/10.24071/llt.2012.150102
Nigeria is a patriarchal society characterized by acute discrimination, exclusion, inequality and impunity. These features are also reflected in its politics, especially as they relate to the issue of gender imbalance. This asymmetrical relationship between the sexes in the process of authoritative allocation of public resources ...
Matheson, Amanda; Wood, Laura; Franklin, Scott V.
Self-reflection is important metacognitive skill, enabling students to build coherence into their learning and embed content in a broader context. While various pedagogical techniques exist to encourage student reflection, little research has examined the differences between formally guided, partially guided and unguided reflections. This study focuses on student responses to online Guided Reflection Forms (GRFs) from students in a first-semester non-physics class and, separately, a sophomore...
Alvyda Liuolienė; Regina Metiūnienė
The aim of the article is to get acquainted with the types of journals used in education to help students to learn. The paper presents some ways of fostering student’s learning through reflective journaling. It also describes the key aspects of a new method ARRIVE cycle in connection with teachers preparation to use reflective journals in a classroom. The article also presents self-assessment in reflective journaling and students’ need to self-evaluate their learning process. Reflective journ...
For the past two years, Ford, Bacon and Davis has been performing technical services for the Department of Energy at the Nevada Test Site in specific development of defense low-level waste management concepts for greater confinement disposal concept with particular application to arid sites. The investigations have included the development of Criteria for Greater Confinement Disposal, NVO-234, which was published in May of 1981 and the draft of the technical concept for Greater Confinement Disposal, with the latest draft published in November 1981. The final draft of the technical concept and design specifications are expected to be published imminently. The document is prerequisite to the actual construction and implementation of the demonstration facility this fiscal year. The GCD Criteria Document, NVO-234 is considered to contain information complimentary and compatible with that being developed for the reserved section 10 CFR 61.51b of the NRCs proposed licensing rule for low level waste disposal facilities
Nelissen, Jo M. C.; Tomic, Welko
This paper discusses the cultural-historical school founded by Vygotsky, Luria, and Leontiev as the theoretical background of Russian educational psychologists who have been studying how children learn to reflect. Two approaches to reflection are examined within the cultural-historical tradition: first, reflection--like other higher psychological…
The idea of reflection is central to the theory and practice of learning--especially learning which is grounded in past or current experience. This paper proposes a working definition of reflection and reviews its origins and recent developments. The author also provides an account of "critical reflection", including its rationale and…
Selmer, Jan; Lauring, Jakob; Feng, Yunxia
to expatriates in Chinese societies. It is possible that older business expatriates will receive more respect and be treated with more deference in a Chinese cultural context than their apparently younger colleagues. This may have a positive impact on expatriates’ job performance. To empirically test...... this presumption, business expatriates in Greater Chine were targeted by a survey. Controlling for the potential bias of a number of background variables, results indicate that contextual/managerial performance, including general managerial functions applied to the subsidiary in Greater China, had a positive...
The article presents the origins and development of the idea of absenteeism in Greater Poland in the 19th century. The start date for the research is 1840, which is considered to be a breakthrough year in the history of an organized absenteeism movement in Greater Poland. It was due to the Association for the Suppression of the Use of Vodka (Towarzystwo ku Przytłumieniu Używania Wódki) in the Great Duchy of Posen that was then established in Kórnik. It was a secular organization that came int...
Parker, Andrew M; Weller, Joshua A
Decision-making competence reflects individual differences in the susceptibility to committing decision-making errors, measured using tasks common from behavioral decision research (e.g., framing effects, under/overconfidence, following decision rules). Prior research demonstrates that those with higher decision-making competence report lower incidence of health-risking and antisocial behaviors, but there has been less focus on intermediate processes that may impact real-world decisions, and, in particular, those implicated by normative models. Here we test the associations between measures of youth decision-making competence (Y-DMC) and one such process, the degree to which individuals make choices consistent with maximizing expected value (EV). Using a task involving hypothetical gambles, we find that greater EV sensitivity is associated with greater Y-DMC. Higher Y-DMC scores are associated with (a) choosing risky options when EV favors those options and (b) avoiding risky options when EV favors a certain option. This relationship is stronger for gambles that involved potential losses. The results suggest that Y-DMC captures decision processes consistent with standard normative evaluations of risky decisions.
Andrew M Parker
Full Text Available Decision-making competence reflects individual differences in the susceptibility to decision-making errors, measured using tasks common from behavioral decision research (e.g., framing effects, under/overconfidence, following decision rules. Prior research demonstrates that those with higher decision-making competence report lower incidence of health-risking and antisocial behaviors, but there has been less focus on intermediate mechanisms that may impact real-world decisions, and, in particular, those implicated by normative models. Here we test the associations between measures of youth decision-making competence (Y-DMC and one such mechanism, the degree to which individuals make choices consistent with maximizing expected value (EV. Using a task involving hypothetical gambles, we find that greater EV sensitivity is associated with greater Y-DMC. Higher Y-DMC scores are associated with (a choosing risky options when expected value favors those options and (b avoiding risky options when expected value favors a certain option. This relationship is stronger for gambles that involved potential losses. The results suggest that Y-DMC captures decision processes consistent with standard normative evaluations of risky decisions.
Research has found that due to similarities, firms which have gained business experience elsewhere in Greater China may exhibit relatively better performance in mainland China. Hence, the experience of business expatriates could be of strategic importance for the expansion path of their firms...
Gaultney, Jane F.
The pediatric literature indicates that children with ADHD are at greater risk for sleep problems, daytime sleepiness, and some sleep disorders than children with no diagnosed disability. It has not been determined whether this pattern holds true among emerging adults, and whether comorbid sleep disorders with ADHD predict GPA. The present study…
Christopher C. Swanson
Greater sage-grouse (Centrocercus urophasianus) populations and the sagebrush (Artemisia spp.) communities that they rely on have dramatically declined from historic levels. Moreover, information regarding sage-grouse annual life-history requirements at the eastern-most extension of sagebrush steppe communities is lacking....
R. Veenhoven (Ruut); F. Vergunst (Floris)
markdownabstract__Abstract__ The 'Easterlin Paradox' holds that economic growth in nations does not buy greater happiness for the average citizen. This thesis was advanced in the 1970s on the basis of the then available data on happiness in nations. Later data have disproved most of the empirical
Describes the problems associated with the management of part-time library employees and some solutions afforded by a job sharing arrangement in use at the Greater Victoria Public Library. This is a voluntary work arrangement, changing formerly full-time positions into multiple part-time positions. (JVP)
Hahm, So Hee; Lee, Ye Ri; Kim, Dong Jin; Sung, Ki Jun; Lim, Jong Nam
To evaluate, if possible, the radiographic features of tuberculous osteitis in the greater trochanter and ischium, and to determine the cause of the lesions. We reterospectively reviewed the plain radiographic findings of 14 ptients with histologically proven tuberculous osteitis involving the greater trochanter and ischium. In each case, the following were analyzed:morphology of bone destruction, including cortical erosion;periosteal reaction;presence or abscence of calcific shadows in adjacent soft tissue. On the basis of an analysis of radiographic features and correlation of the anatomy with adjacent structures we attempted to determine causes. Of the 14 cases evaluated, 12 showed varrious degrees of extrinsic erosion on the outer cortical bone of the greater trochanter and ischium ; in two cases, bone destruction was so severe that the radiographic features of advanced perforated osteomyelitis were simulated. In addition to findings of bone destruction, in these twelve cases, the presence of sequestrum or calcific shadows was seen in adjacent soft tissue. Tuberculous osteitis in the greater trochanter and ischium showed the characteristic findings of chronic extrinsic erosion. On the basis of these findings we can suggest that these lesions result from an extrinsic pathophysiologic cause such as adjacent bursitis
Hahm, So Hee; Lee, Ye Ri [Hanil Hospital Affiliated to KEPCO, Seoul (Korea, Republic of); Kim, Dong Jin; Sung, Ki Jun [Yonsei Univ. Wonju College of Medicine, Wonju (Korea, Republic of); Lim, Jong Nam [Konkuk Univ. College of Medicine, Seoul (Korea, Republic of)
To evaluate, if possible, the radiographic features of tuberculous osteitis in the greater trochanter and ischium, and to determine the cause of the lesions. We reterospectively reviewed the plain radiographic findings of 14 ptients with histologically proven tuberculous osteitis involving the greater trochanter and ischium. In each case, the following were analyzed:morphology of bone destruction, including cortical erosion;periosteal reaction;presence or abscence of calcific shadows in adjacent soft tissue. On the basis of an analysis of radiographic features and correlation of the anatomy with adjacent structures we attempted to determine causes. Of the 14 cases evaluated, 12 showed varrious degrees of extrinsic erosion on the outer cortical bone of the greater trochanter and ischium ; in two cases, bone destruction was so severe that the radiographic features of advanced perforated osteomyelitis were simulated. In addition to findings of bone destruction, in these twelve cases, the presence of sequestrum or calcific shadows was seen in adjacent soft tissue. Tuberculous osteitis in the greater trochanter and ischium showed the characteristic findings of chronic extrinsic erosion. On the basis of these findings we can suggest that these lesions result from an extrinsic pathophysiologic cause such as adjacent bursitis.
Harley, J.P. Jr.; Wilhite, E.L.; Jaegge, W.J.
Greater Confinement Disposal (GCD) facilities have been constructed within the operating burial ground at the Savannah River Plant (SRP) to dispose of the higher activity fraction of SRP low-level waste. GCD practices of waste segregation, packaging, emplacement below the root zone, and waste stabilization are being used in the demonstration. 2 refs., 2 figs., 2 tabs
Saintot, A.N.; Brunet, M.F.; Yakovlev, F.; Sébrier, M.; Stephenson, R.A.; Ershov, A.V.; Chalot-Prat, F.; McCann, T.
The Greater Caucasus (GC) fold-and-thrust belt lies on the southern deformed edge of the Scythian Platform (SP) and results from the Cenoozoic structural inversion of a deep marine Mesozoic basin in response to the northward displacement of the Transcaucasus (lying south of the GC subsequent to the
Deegan, John, Jr.
It is demonstrated here that standardized regression coefficients greater than one can legitimately occur. Furthermore, the relationship between the occurrence of such coefficients and the extent of multicollinearity present among the set of predictor variables in an equation is examined. Comments on the interpretation of these coefficients are…
Following its late nineteenth-century emergence as an important element within federalist thinking across the British Empire, the idea of Greater Britain lost much of its political force in the years following the Boer War. The concept however continued to retain considerable residual currency in other fields of Imperial debate, including those…
Langley, Malinda E; Brown, Sylvia T
The purpose of this study was to examine the perceptions of graduate nursing students and a small sample of faculty regarding learning outcomes associated with reflective learning journals (RLJ) in online education. Reflective journaling is used extensively in nursing curricula, yet few studies have explored perceptions of learning outcomes with online students, specifically those preparing to become nurse educators.An electronic survey was developed utilizing items associated with four learning outcomes of reflective journaling: professional development, personal growth, empowerment, and facilitation of the learning process. Positive outcomes such as the connection between theory and practice, recognition of strengths and weaknesses, and integration of new ideas and concepts were identified. Obstacles included the amount of time needed for reflection and grading, and the development of trust between students and faculty. The results of this study indicate that graduate students and faculty perceive positive learning outcomes with the use of reflective journals in online education.
Höger, C; Temme, M; Geiken, G
In an evaluation study we investigated the effectiveness of the reflecting team approach compared to eclectic child psychiatric treatment in an outpatient setting and the indications for each type of treatment. The relationship between treatment outcome and diagnostic data obtained with the Multi-axial Classification Scheme was examined in 22 families treated with the reflecting team approach and in a second group of families matched on all important sociodemographic and diagnostic variables but receiving eclectic treatment. No difference was found between the two groups regarding symptom improvement or changes in family functioning. Regarding satisfaction with treatment, the reflecting team approach was superior to the eclectic modality. In the reflecting team group parental mental disorder and inadequate intra-familial communication (according to the new fifth axis of the Multi-axial Classification Scheme) had a negative effect on outcome.
Ballard, Kristy K.; McBride, Ron
From Dewey (1933) to present, reflectivity is an important component of teacher education. Little information exists that specifically addresses when changes in reflectivity might occur. Therefore, the purpose of this study was: (a) to apply Van Manen's model to outcomes to examine levels of, and changes in, reflectivity and (b) to verify the…
Hill, Anne E.; Davidson, Bronwyn J.; Theodoros, Deborah G.
Background: Reflective practice is reported to enhance clinical reasoning and therefore to maximize client outcomes. The inclusion of targeted reflective practice in academic programmes in speech-language therapy has not been consistent, although providing opportunities for speech-language therapy students to reflect during their clinical practice…
This paper contributes to insights on teachers’ thinking and practice by building partly on the large amount of prior research in the field of continuing professional development (in line with ISATT), and partly on examples from an empirical small-scale study executed in Denmark. The purpose of t......’ reflections on practice. Based on this model, the paper provides a proposal regarding how to work with teachers’ professional development and learning processes. Educational implications and future research directions are discussed.......This paper contributes to insights on teachers’ thinking and practice by building partly on the large amount of prior research in the field of continuing professional development (in line with ISATT), and partly on examples from an empirical small-scale study executed in Denmark. The purpose...... of the Danish study was to investigate and understand teachers’ classroom experiences using Fenstermacher’s approach to develop a practical argument, as these classroom experiences are regarded as a potential source of learning for teachers. A three-level scale model from the study describes the teach-ers...
Babalola, Dolapo A.; Omole, Folashade
An increasing number of studies are confirming an association between periodontal disease (PD) and adverse outcomes in pregnancy. PD places pregnant women at greater risk for preterm birth than alcohol consumption or smoking. This underscores the importance of offering dental screening to women who are pregnant or contemplating pregnancy and the need for physicians who provide obstetric care to be aware of the possible connection between poor dental health and poor pregnancy outcomes.
Dolapo A. Babalola
Full Text Available An increasing number of studies are confirming an association between periodontal disease (PD and adverse outcomes in pregnancy. PD places pregnant women at greater risk for preterm birth than alcohol consumption or smoking. This underscores the importance of offering dental screening to women who are pregnant or contemplating pregnancy and the need for physicians who provide obstetric care to be aware of the possible connection between poor dental health and poor pregnancy outcomes.
Hansen, Lone Hersted
Whether an organization prospers depends importantly on the relationships among its participants, and central to the success of relationships is the process of dialogue. This article describes an action-based educational practice for enhancing dialogical and relational skills among members of an ...... to the outcomes of reflective role-playing for acquiring bodily awareness, changing and expanding perspectives, developing critical self-reflection, and enhancing relational consciousness....
Ohkura, Yu; Haruta, Shusuke; Shindoh, Junichi; Tanaka, Tsuyoshi; Ueno, Masaki; Udagawa, Harushi
For proximal gastric cancer invading the greater curvature, concomitant splenectomy is frequently performed to secure the clearance of lymph node metastases. However, prognostic impact of prophylactic splenectomy remains unclear. The aim of this study was to clarify the oncological significance of prophylactic splenectomy for advanced proximal gastric cancer invading the greater curvature. Retrospective review of 108 patients who underwent total or subtotal gastrectomy for advanced proximal gastric cancer involving the greater curvature was performed. Short-term and long-term outcomes were compared between the patients who underwent splenectomy (n = 63) and those who did not (n = 45). Patients who underwent splenectomy showed higher amount of blood loss (538 vs. 450 mL, p = 0.016) and morbidity rate (30.2 vs. 13.3, p = 0.041) compared with those who did not undergo splenectomy. In particular, pancreas-related complications were frequently observed among patients who received splenectomy (17.4 vs. 0%, p = 0.003). However, no significant improvement of long-term outcomes were confirmed in the cases with splenectomy (5-year recurrence-free rate, 60.2 vs. 67.3%; p = 0.609 and 5-year overall survival rates, 63.7 vs. 73.6%; p = 0.769). On the other hand, splenectomy was correlated with marginally better survival in patients with Borrmann type 1 or 2 gastric cancer (p = 0.072). For advanced proximal gastric cancer involving the greater curvature, prophylactic splenectomy may have no significant prognostic impact despite the increased morbidity rate after surgery. Such surgical procedure should be avoided as long as lymph node involvement is not evident.
The design and performance of multiple-layer, selective-reflection, selective-suppression coatings for the 900 - 1200 A band are described. These coatings are designed to optimize both high reflectivity at a desirable wavelength and low reflectivity at an undesirable wavelength. The minimum structure for a selective coating consists of a thin metal or metal oxide layer (50 - 150 A thickness) over an aluminum substrate protected with a semi-transparent dielectric (100 - 1000 A thickness). Predicted coating performance is strongly effected by varying the layer combination and thickness. A graphical method of optimizing the coating layer structure is developed. Aluminum, silicon, their oxides, and gold have been investigated as coating layer materials. A very simple coating with a 1026 to 1216 A reflectivity ratio greater than 100 was fabricated. Such reflection/suppression coatings may be of great utility to spaceborne EUV spectrographs.
Riemer, Hila; Viswanathan, Madhu
This research examines control over the effect of arousal, a dimension of affect, on judgement. Past research shows that high processing motivation enhances control over the effects of affect on judgement. Isolating and studying arousal as opposed to valence, the other dimension of affect, and its effect on judgement, we identify boundary conditions for past findings. Drawing from the literature on processes by which arousal influences judgement, we demonstrate that the role of motivation is contingent upon the type of judgement task (i.e., memory- versus stimulus-based judgement). In stimulus-based judgement, individuals exert greater control over the effect of arousal on judgement under low compared to high motivation. In contrast, in memory-based judgement individuals exert greater control over the effect of arousal under high compared to low motivation. Theoretical implications and avenues for future research are discussed.
Tandon, Ankit Anil; Lim, Kian Soon
Torsion of the greater omentum is a rare acute abdominal condition that is seldom diagnosed preoperatively. We report the characteristic computed tomography (CT) scan findings and the clinical implications of this unusual diagnosis in a 41-year-old man, who also had longstanding right inguinal hernia. Awareness of omental torsion as a differential diagnosis in the acute abdomen setting is necessary for correct patient management
Reynolds, R Graham; Collar, David C; Pasachnik, Stesha A; Niemiller, Matthew L; Puente-Rolón, Alberto R; Revell, Liam J
Colonization of islands can dramatically influence the evolutionary trajectories of organisms, with both deterministic and stochastic processes driving adaptation and diversification. Some island colonists evolve extremely large or small body sizes, presumably in response to unique ecological circumstances present on islands. One example of this phenomenon, the Greater Antillean boas, includes both small (<90 cm) and large (4 m) species occurring on the Greater Antilles and Bahamas, with some islands supporting pairs or trios of body-size divergent species. These boas have been shown to comprise a monophyletic radiation arising from a Miocene dispersal event to the Greater Antilles, though it is not known whether co-occurrence of small and large species is a result of dispersal or in situ evolution. Here, we provide the first comprehensive species phylogeny for this clade combined with morphometric and ecological data to show that small body size evolved repeatedly on separate islands in association with specialization in substrate use. Our results further suggest that microhabitat specialization is linked to increased rates of head shape diversification among specialists. Our findings show that ecological specialization following island colonization promotes morphological diversity through deterministic body size evolution and cranial morphological diversification that is contingent on island- and species-specific factors. © 2016 The Author(s). Evolution © 2016 The Society for the Study of Evolution.
Webber, Emily S; Mankin, David E; Cromwell, Howard C
The striatum is a key brain region involved in reward processing. Striatal activity has been linked to encoding reward magnitude and integrating diverse reward outcome information. Recent work has supported the involvement of striatum in the valuation of outcomes. The present work extends this idea by examining striatal activity during dynamic shifts in value that include different levels and directions of magnitude disparity. A novel task was used to produce diverse relative reward effects on a chain of instrumental action. Rats ( Rattus norvegicus ) were trained to respond to cues associated with specific outcomes varying by food pellet magnitude. Animals were exposed to single-outcome sessions followed by mixed-outcome sessions, and neural activity was compared among identical outcome trials from the different behavioral contexts. Results recording striatal activity show that neural responses to different task elements reflect incentive contrast as well as other relative effects that involve generalization between outcomes or possible influences of outcome variety. The activity that was most prevalent was linked to food consumption and post-food consumption periods. Relative encoding was sensitive to magnitude disparity. A within-session analysis showed strong contrast effects that were dependent upon the outcome received in the immediately preceding trial. Significantly higher numbers of responses were found in ventral striatum linked to relative outcome effects. Our results support the idea that relative value can incorporate diverse relationships, including comparisons from specific individual outcomes to general behavioral contexts. The striatum contains these diverse relative processes, possibly enabling both a higher information yield concerning value shifts and a greater behavioral flexibility.
Asselin, Marilyn E; Fain, James A
A mixed-method study was conducted to determine whether nurses' participation in a reflective practice continuing education program using a structured reflection model makes a difference in nurses' self-reflection, insight, and reflective thinking about clinical practice situations. Findings suggested that use of structured reflection using question cues, written narratives, and peer-facilitated reflection increased nurses' engagement in self-reflection and enhanced reflective thinking in practice. Including reflective practice education in novice orientation and preceptor training may be beneficial.
Full Text Available Plant functional groups—in our case grass, herbs, and legumes—and their spatial distribution can provide information on key ecosystem functions such as species richness, nitrogen fixation, and erosion control. Knowledge about the spatial distribution of plant functional groups provides valuable information for grassland management. This study described and mapped the distribution of grass, herb, and legume coverage of the subalpine grassland in the high-mountain Kazbegi region, Greater Caucasus, Georgia. To test the applicability of new sensors, we compared the predictive power of simulated hyperspectral canopy reflectance, simulated multispectral reflectance, simulated vegetation indices, and topographic variables for modeling plant functional groups. The tested grassland showed characteristic differences in species richness; in grass, herb, and legume coverage; and in connected structural properties such as yield. Grass (Hordeum brevisubulatum was dominant in biomass-rich hay meadows. Herb-rich grassland featured the highest species richness and evenness, whereas legume-rich grassland was accompanied by a high coverage of open soil and showed dominance of a single species, Astragalus captiosus. The best model fits were achieved with a combination of reflectance, vegetation indices, and topographic variables as predictors. Random forest models for grass, herb, and legume coverage explained 36%, 25%, and 37% of the respective variance, and their root mean square errors varied between 12–15%. Hyperspectral and multispectral reflectance as predictors resulted in similar models. Because multispectral data are more easily available and often have a higher spatial resolution, we suggest using multispectral parameters enhanced by vegetation indices and topographic parameters for modeling grass, herb, and legume coverage. However, overall model fits were merely moderate, and further testing, including stronger gradients and the addition of
Milinkovic, Danielle; Field, Nikki
Student learning on clinical placement is a complex issue and cannot be defined solely by just doing things. Reflection during clinical practice is essential if the student is going to learn from the experience. Therefore it is important for educators to include as part of clinical education programs learning strategies that encourage reflection. The reflective clinical journal is an educational tool that is employed by the School of Medical Radiation Sciences at the University of Sydney to encourage reflection of undergraduate radiation therapy students whilst on clinical placement. This discussion paper explores the key concepts of reflection and the reflective clinical journal. Due to the paucity of information about this issue in radiation therapy the literature reviewed is from across all areas of the health sciences
Full Text Available The article presents the origins and development of the idea of absenteeism in Greater Poland in the 19th century. The start date for the research is 1840, which is considered to be a breakthrough year in the history of an organized absenteeism movement in Greater Poland. It was due to the Association for the Suppression of the Use of Vodka (Towarzystwo ku Przytłumieniu Używania Wódki in the Great Duchy of Posen that was then established in Kórnik. It was a secular organization that came into being on an initiative of doctor De La Roch, who was a German surgeon of a French origin. However, as early as 1844, the idea of absenteeism raised an interest of catholic clergymen of Greater Poland with high ranking clergy such as Rev. Leon Michał Przyłuski, Archbishop of Gniezno and Rev. Jan Kanty Dąbrowski, Archbishop of Posen, and later on Archbishops Rev. Mieczysław Halka Ledóchowski and Rev. Florian Oksza Stablewski. They were fascinated with activities of Rev. Jan Nepomucen Fick, Parish Priest of Piekary Śląskie and several other priests on whose initiative a lot of church brotherhoods of so called holy continence were set up in Upper Silesia as early as the first half-year of 1844. It was due to Bishop Dąbrowski that 100 000 people took vows of absenteeism in 1844–1845, becoming members of brotherhoods of absenteeism. In turn, it was an initiative of Archbishop Przyłuski that Jesuit missionaries – Rev. Karol Bołoz Antoniewicz, Rev. Teofil Baczyński and Rev. Kamil Praszałowicz, arrived in Greater Poland from Galicia in 1852 to promote the idea of absenteeism. Starting from 1848, they were helping Silesian clergymen to spread absenteeism. Clergymen of Greater Poland were also active in secular absenteeism associations. They became involved in the workings of the Association for the Promotion of Absenteeism that was set up by Zygmunt Celichowski in Kórnik in 1887, and especially in the Jutrzenka Absenteeism Association
Henckel, D.; Arnold, G.; Kappel, D.; Moroz, L. V.; Markus, K.
The Berlin Reflectance Spectral Library (BRSL) provides a collection of reflectance spectra between 0.3 and 17 µm. It was originally dedicated to support space missions to small solar system bodies. Meanwhile the library includes selections of biconical reflectance spectra for spectral data analysis of other planetary bodies as well. The library provides reference spectra of well-characterized terrestrial analogue materials and meteorites for interpretation of remote sensing reflectance spectra of planetary surfaces. We introduce the BRSL, summarize the data available, and access to use them for further relevant applications.
Full Text Available The aim of the article is to get acquainted with the types of journals used in education to help students to learn. The paper presents some ways of fostering student’s learning through reflective journaling. It also describes the key aspects of a new method ARRIVE cycle in connection with teachers preparation to use reflective journals in a classroom. The article also presents self-assessment in reflective journaling and students’ need to self-evaluate their learning process. Reflective journaling as central to students’ self-evaluation is described as a means of fostering metacognition.
Lanchester, P. C.
An inexpensive apparatus and associated experiments are described for studying the basic laws of reflection and refraction of light at an air-glass interface, and multiple internal reflections within a glass block. In order to motivate students and encourage their active participation, a novel technique is described for determining the refractive…
Full Text Available Teaching is a complex profession, which is further complicated by the integration of technology into classrooms. Reflection can help teachers unpack the complexity in their practice. Reflection can be an effective instructional strategy in helping preservice teachers develop technological pedagogical content knowledge (TPACK, the complex and dynamic knowledge necessary for effective technology integration into instruction. In this study, reflective activities were integrated into a Learning By Design (LBD environment, which was created to help preservice teachers develop TPACK. This paper investigated the participants’ TPACK development and examined how reflection helped them construct TPACK. Through content analysis of the participants’ reflective journals, the researcher found that the preservice teachers developed initial TPACK awareness. However, their reflection in technology knowledge and the content aspects of TPACK were limited and superficial. Interviews with the participants showed reflection helped the preservice teachers remember what they learned by describing and elaborating on their in-class experiences, pushed them to think about how to apply what they learned in their future classrooms, and helped them become more reflective and open-minded about using technology in classrooms. Finally, the researcher discussed this study’s implications for teacher educators and researchers.
Cushion, Christopher J.
Reflection and reflective practice is seen as an established part of coaching and coach education practice. It has become a "taken-for-granted" part of coaching that is accepted enthusiastically and unquestioningly, and is assumed to be "good" for coaching and coaches. Drawing on sociological concepts, a primarily Foucauldian…
Stewart, Jim; Keegan, Anne; Stevens, Pam
Purpose: This paper aims to explore how teaching and assessing reflective learning skills can support postgraduate practitioners studying organisational change and explores the challenges for tutors in assessing these journals. Design/methodology/approach: Assessment criteria were developed from the literature on reflective practice and…
Brosnan, Mark; Ashwin, Chris; Lewton, Marcus
Dual Process Theory has recently been applied to Autism spectrum disorder (ASD) to suggest that reasoning by people with ASD and people with higher levels of ASD-like traits can be characterised by reduced intuitive and greater reflective processing. 26 adolescents and adults with ASD and 22 adolescent and adult controls completed an assessment of…
Brody, Stuart; Krüger, Tillmann H C
Research indicates that prolactin increases following orgasm are involved in a feedback loop that serves to decrease arousal through inhibitory central dopaminergic and probably peripheral processes. The magnitude of post-orgasmic prolactin increase is thus a neurohormonal index of sexual satiety. Using data from three studies of men and women engaging in masturbation or penile-vaginal intercourse to orgasm in the laboratory, we report that for both sexes (adjusted for prolactin changes in a non-sexual control condition), the magnitude of prolactin increase following intercourse is 400% greater than that following masturbation. The results are interpreted as an indication of intercourse being more physiologically satisfying than masturbation, and discussed in light of prior research reporting greater physiological and psychological benefits associated with coitus than with any other sexual activities.
Full Text Available The starting-point for the article is to provide a brief background on the Ubuntu Project that Prof. Drucilla Cornell convened in 2003; most notably the interviews conducted in Khayamandi, the support of a sewing collective, and the continued search to launch an Ubuntu Women�s Centre. The article will reflect on some of the philosophical underpinnings of ubuntu, whereafter debates in Western feminism will be revisited. Ubuntu feminism is suggested as a possible response to these types of feminisms. The authors support an understanding of ubuntu as critique and ubuntu feminism accordingly as a critical intervention that recalls a politics of refusal. The article ends by raising the importance of thinking about spatiality through ubuntu, and vice versa. It may seem strange to title an article Ubuntu feminism when feminism itself has often been identified as a European or Western idea. But, this article will argue that ubuntu offers conceptions of transindividuality and ways of social belonging that could respond in a meaningful way to some of European feminism�s own dilemmas and contradictions. Famously, one of the most intense debates in feminism was between those who defended an ethic of care in a relational view of the self, on one side, and those feminists who held on to more traditional conceptions of justice, placing an emphasis on individuality and autonomy, on the other side. The authors will suggest that ubuntu could address this tension in feminism. Thus, in this article the focus will not simply be on ubuntu, in order to recognise that there are other intellectual heritages worthy of consideration, other than those in Europe and the United States. It will also take a next step in arguing that ubuntu may be a better standpoint entirely from which to continue thinking about what it means to be a human being, as well as how to conceive of the integral interconnection human beings all have with one another. This connection through
Zheng, Jun; Zhang, Wei; Li, Tongtong; Liu, Zhaomin; Luo, Liang
A wealth of research has shown that retrieval practice plays a significant role in improving memory retention. The current study focused on one simple yet rarely examined question: would repeated retrieval using two different retrieval routes or using the same retrieval route twice lead to greater long-term memory retention? Participants elaborately learned 22 Japanese-Chinese translation word pairs using two different mediators. Half an hour after the initial study phase, the participants completed two retrieval sessions using either one mediator (Tm1Tm1) or two different mediators (Tm1Tm2). On the final test, which was performed 1week after the retrieval practice phase, the participants received only the cue with a request to report the mediator (M1 or M2) followed by the target (Experiment 1) or only the mediator (M1 or M2) with a request to report the target (Experiment 2). The results of Experiment 1 indicated that the participants who practiced under the Tm1Tm2 condition exhibited greater target retention than those who practiced under the Tm1Tm1 condition. This difference in performance was due to the significant disadvantage in mediator retrieval and decoding of the unpracticed mediator under the Tm1Tm1 condition. Although mediators were provided to participants on the final test in Experiment 2, decoding of the unpracticed mediators remained less effective than decoding of the practiced mediators. We conclude that practicing multiple retrieval routes leads to greater memory retention than focusing on a single retrieval route. Thus, increasing retrieval variability during repeated retrieval practice indeed significantly improves long-term retention in a delay test. Copyright © 2016 Elsevier B.V. All rights reserved.
Bukhari, Areej; Luis, Javier Rodriguez; Alfonso-Sanchez, Miguel A; Garcia-Bertrand, Ralph; Herrera, Rene J
Notwithstanding the general interest and the geopolitical importance of the island countries in the Greater Antilles, little is known about the specific ancestral Native American and African populations that settled them. In an effort to alleviate this lacuna of information on the genetic constituents of the Greater Antilles, we comprehensively compared the mtDNA compositions of Cuba, Dominican Republic, Haiti, Jamaica and Puerto Rico. To accomplish this, the mtDNA HVRI and HVRII regions, as well as coding diagnostic sites, were assessed in the Haitian general population and compared to data from reference populations. The Taino maternal DNA is prominent in the ex-Spanish colonies (61.3%-22.0%) while it is basically non-existent in the ex-French and ex-English colonies of Haiti (0.0%) and Jamaica (0.5%), respectively. The most abundant Native American mtDNA haplogroups in the Greater Antilles are A2, B2 and C1. The African mtDNA component is almost fixed in Haiti (98.2%) and Jamaica (98.5%), and the frequencies of specific African haplogroups vary considerably among the five island nations. The strong persistence of Taino mtDNA in the ex-Spanish colonies (and especially in Puerto Rico), and its absence in the French and English excolonies is likely the result of different social norms regarding mixed marriages with Taino women during the early years after the first contact with Europeans. In addition, this article reports on the results of an integrative approach based on mtDNA analysis and demographic data that tests the hypothesis of a southward shift in raiding zones along the African west coast during the period encompassing the Transatlantic Slave Trade. Copyright © 2017 Elsevier B.V. All rights reserved.
Joseph, Pamela Bolotin
This study analyzes narratives written in a culminating graduate seminar on reflective practice by 36 new secondary teachers who were asked to consider their moral beliefs, moral values and system of ethics as they reflected on their recent student teaching experiences. The findings explore how the participants depicted their constructed moral…
Cholesteric liquid crystals (ChLCs) exhibit two stable states at zero field condition-the reflecting planar state and the nonreflecting focal conic state. ChLCs are an excellent candidate for inexpensive and rugged electronic books and papers. This paper will review the display cell structure,materials and drive schemes for flexible bistable cholesteric (Ch) reflective displays.
Sutherland, J.C.; Griffin, K.P.
Although DNA absorption at wavelengths greater than 300 nm is much weaker than that at shorter wavelengths, this absorption seems to be responsible for much of the biological damage caused by solar radiation of wavelengths less than 320 nm. Accurate measurement of the absorption spectrum of DNA above 300 nm is complicated by turbidity characteristic of concentrated solutions of DNA. We have measured the absorption spectra of DNA from calf thymus, Clostridium perfringens, Escherichia coli, Micrococcus luteus, salmon testis, and human placenta using procedures which separate optical density due to true absorption from that due to turbidity. Above 300 nm, the relative absorption of DNA increases as a function of guanine-cytosine content, presumably because the absorption of guanine is much greater than the absorption of adenine at these wavelengths. This result suggests that the photophysical processes which follow absorption of a long-wavelength photon may, on the average, differ from those induced by shorter-wavelength photons. It may also explain the lower quantum yield for the killing of cells by wavelengths above 300 nm compared to that by shorter wavelengths
Dean, Lorraine T; DeMichele, Angela; LeBlanc, Mously; Stephens-Shields, Alisa; Li, Susan Q; Colameco, Chris; Coursey, Morgan; Mao, Jun J
Over one-third of breast cancer survivors experience upper extremity disability. Black women present with factors associated with greater upper extremity disability, including: increased body mass index (BMI), more advanced disease stage at diagnosis, and varying treatment type compared with Whites. No prior research has evaluated the relationship between race and upper extremity disability using validated tools and controlling for these factors. Data were drawn from a survey study among 610 women with stage I-III hormone receptor positive breast cancer. The disabilities of the arm, shoulder and hand (QuickDASH) is an 11-item self-administered questionnaire that has been validated for breast cancer survivors to assess global upper extremity function over the past 7 days. Linear regression and mediation analysis estimated the relationships between race, BMI and QuickDASH score, adjusting for demographics and treatment types. Black women (n = 98) had 7.3 points higher average QuickDASH scores than White (n = 512) women (p disability by 40 %. Even several years post-treatment, Black breast cancer survivors had greater upper extremity disability, which was partially mediated by higher BMIs. Close monitoring of high BMI Black women may be an important step in reducing disparities in cancer survivorship. More research is needed on the relationship between race, BMI, and upper extremity disability.
Trevorrow, L.E.; Gilbert, T.L.; Luner, C.; Merry-Libby, P.A.; Meshkov, N.K.; Yu, C.
Low-level radioactive wastes include a broad spectrum of wastes that have different radionuclide concentrations, half-lives, and physical and chemical properties. Standard shallow-land burial practice can provide adequate protection of public health and safety for most low-level wastes, but a small volume fraction (about 1%) containing most of the activity inventory (approx.90%) requires specific measures known as ''greater-confinement disposal'' (GCD). Different site characteristics and different waste characteristics - such as high radionuclide concentrations, long radionuclide half-lives, high radionuclide mobility, and physical or chemical characteristics that present exceptional hazards - lead to different GCD facility design requirements. Facility design alternatives considered for GCD include the augered shaft, deep trench, engineered structure, hydrofracture, improved waste form, and high-integrity container. Selection of an appropriate design must also consider the interplay between basic risk limits for protection of public health and safety, performance characteristics and objectives, costs, waste-acceptance criteria, waste characteristics, and site characteristics. This paper presents an overview of the factors that must be considered in planning the application of methods proposed for providing greater confinement of low-level wastes. 27 refs
Chua, Li Wen; Milfont, Taciano L; Jose, Paul E
Adolescents who endorse greater levels of future orientation report greater well-being over time, but we do not know the mechanism by which this happens. The present longitudinal study examined whether both adaptive as well as maladaptive coping strategies might explain how future orientation leads to ill-being and well-being over time in young New Zealanders. A sample of 1,774 preadolescents and early adolescents (51.9 % female) aged 10-15 years at Time 1 completed a self-report survey three times with 1 year intervals in between. Longitudinal mediation path models were constructed to determine whether and how maladaptive and adaptive coping strategies at Time 2 functioned as mediators between future orientation at Time 1 and ill-being and well-being at Time 3. Results showed that future orientation predicted lower maladaptive coping, which in turn predicted lower substance use and self-harming behavior. All three well-being outcomes (i.e., happiness with weight, vitality, and sleep) were consistently predicted by future orientation, and all three pathways were mediated by both lower maladaptive and higher adaptive coping strategies (with the exception of happiness with weight, which was mediated only by lower maladaptive coping). The results suggest that several pathways by which future orientation leads to greater well-being occurs through an increased use of adaptive coping, a decreased use of maladaptive coping, or both.
Kroon, R. E.
Luminescent materials are useful in applications varying from lighting and display technologies to document security features and medical research, amongst many others. Measurement of the excitation range is an important consideration, and absorption bands are often determined from a decrease in the measured diffuse reflectance of the material using a ultraviolet-visible (UV-vis) spectrophotometer with an integrating sphere. Such a system may provide questionable results when used to measure the reflectance of a luminescence material, which is demonstrated for a Tb doped silica phosphor, because the system cannot differentiate between the reflected light and luminescence. It is shown that more reliable results are achieved for this phosphor by measuring the reflectance using a synchronous zero-offset scan in a fluorescence spectrometer equipped with an integrating sphere. This method is therefore recommended instead of traditional reflectance measurements using a UV-vis spectrophotometer for luminescent powders.
In the psychological sciences, mindfulness practices are increasingly being used, studied, and theorized, but their indigenous theoretical foundations in Buddhist accounts of the dynamics and psychology of personal identity tend to be overlooked. This situation is mirrored in the discipline of philosophy: here, Buddhist views on personal identity are beginning to draw attention, but almost invariably in a way which entirely blanks out the role of mindfulness practices in cultivating Buddhist insights on selfhood. The aggregate result is a failure, in the West, to reflect upon and seriously consider Buddhist theory and Buddhist practice in an integrated, holistic fashion. In its effort to overcome the compartmentalization of Buddhist theory (in philosophy) versus Buddhist practice (in psychology) and to embrace the challenges this might pose to fundamental Western beliefs about the self, this paper is intended both as a plea for and an exercise in greater, more venturesome cosmopolitanism. © The Author(s) 2015.
Pachur, Thorsten; Schulte-Mecklenbeck, Michael; Murphy, Ryan O; Hertwig, Ralph
There is a disconnect in the literature between analyses of risky choice based on cumulative prospect theory (CPT) and work on predecisional information processing. One likely reason is that for expectation models (e.g., CPT), it is often assumed that people behaved only as if they conducted the computations leading to the predicted choice and that the models are thus mute regarding information processing. We suggest that key psychological constructs in CPT, such as loss aversion and outcome and probability sensitivity, can be interpreted in terms of attention allocation. In two experiments, we tested hypotheses about specific links between CPT parameters and attentional regularities. Experiment 1 used process tracing to monitor participants' predecisional attention allocation to outcome and probability information. As hypothesized, individual differences in CPT's loss-aversion, outcome-sensitivity, and probability-sensitivity parameters (estimated from participants' choices) were systematically associated with individual differences in attention allocation to outcome and probability information. For instance, loss aversion was associated with the relative attention allocated to loss and gain outcomes, and a more strongly curved weighting function was associated with less attention allocated to probabilities. Experiment 2 manipulated participants' attention to losses or gains, causing systematic differences in CPT's loss-aversion parameter. This result indicates that attention allocation can to some extent cause choice regularities that are captured by CPT. Our findings demonstrate an as-if model's capacity to reflect characteristics of information processing. We suggest that the observed CPT-attention links can be harnessed to inform the development of process models of risky choice. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
van der Meer, Lisette; de Vos, Annerieke E.; Stiekema, Annemarie P. M.; Pijnenborg, Gerdina H. M.; van Tol, Marie-Jose; Nolen, Willem A.; David, Anthony S.; Aleman, Andre
Background: Impaired insight is a common feature in psychosis and an important predictor of variables such as functional outcome, prognosis, and treatment adherence. A cognitive process that may underlie insight in psychosis is self-reflection, or the conscious evaluation of one's traits and
In a recent commentary, Dr. Abhishek Biswas asks the question whether physicians should rely on their "gut feeling" when making clinical decisions. Biswas describes a situation where his intuition resulted in an immediate course of action that prompted urgent medical attention for a patient who had "routine" pain. Inspired by the author's account, I would like to further Biswas' discussion and examine its importance using the educational theories of Donald Schön and his concept of the reflective practitioner. Schön argues that technical knowledge alone is not sufficient to solve the complex problems that professionals face on a daily basis and intuition, developed through a reflective practice, is crucial for any professional's practice, especially in a time of greater uncertainty in the workplace.
Jones, L.M.; Kesler, S.E.
The strontium isotope geochemistry is given for three Puerto Rican intrusive rocks: the granodioritic Morovis and San Lorenzo plutons and the Rio Blanco stock of quartz dioritic composition. The average calculated initial 87 Sr/ 86 Sr ratios are 0.70370, 0.70355 and 0.70408, respectively. In addition, the San Lorenzo data establish a whole-rock isochron of 71 +- 2 m.y., which agrees with the previously reported K-Ar age of 73 m.y. Similarity of most of the intrusive rocks in the Greater Antilles with respect to their strontium isotopic geochemistry regardless of their major element composition indicates that intrusive magmas with a wide range of composition can be derived from a single source material. The most likely source material, in view of the available isotopic data, is the mantle wedge overlying the subduction zone. (orig.)
I examined the relationship of recalled and diary recorded frequency of penile-vaginal intercourse (FSI), noncoital partnered sexual activity, and masturbation to measured waist and hip circumference in 120 healthy adults aged 19-38. Slimmer waist (in men and in the sexes combined) and slimmer hips (in men and women) were associated with greater FSI. Slimmer waist and hips were associated with rated importance of intercourse for men. Noncoital partnered sexual activity had a less consistent association with slimness. Slimmer waist and hips were associated with less masturbation (in men and in the sexes combined). I discuss the results in terms of differences between different sexual behaviors, attractiveness, emotional relatedness, physical sensitivity, sexual dysfunction, sociobiology, psychopharmacological aspects of excess fat and carbohydrate consumption, and implications for sex therapy.
Full Text Available We examine the relationship between firm valuation and governance mechanisms, firm characteristics, and institutional factors of the American Depository Receipts (ADRs domiciled in the Greater China region. We find that China ADRs have the highest market-to-book value ratio followed by Hong Kong and Taiwan ADRs. It appears that Chinese firms with the poorest external governance environment stand to benefit the most from cross listing under the ADR programs. Listing in the U.S. that requires more stringent regulations and disclosure rules may strengthen the firms’ governance practices and thereby enhance their firm value. Among the internal governance mechanisms, institutional ownership and insider ownership are important for firm value.
Cook, J.R.; Towler, O.A.; Peterson, D.L.; Johnson, G.M.; Helton, B.D.
The first facility to demonstrate Greater Confinement Disposal (GCD) in a humid environment in the United States has been built and is operating at the Savannah River Plant. GCD practices of waste segregation, packaging, emplacement below the root zone, and waste stabilization are being used in the demonstration. Activity concentrations to select wastes for GCD are based on a study of SRP burial records, and are equal to or less than those for Class B waste in 10CFR61. The first disposal units to be constructed are 9-foot diameter, thirty-foot deep boreholes which will be used to dispose of wastes from production reactors, tritiated wastes, and selected wastes from off-site. In 1984 an engineered GCD trench will be constructed for disposal of boxed wastes and large bulky items. 2 figures, 1 table
Towler, O.A.; Cook, J.R.; Peterson, D.L.
Plans for improved LLW disposal at the Savannah River Plant include Greater Confinement Disposal (GCD) for the higher activity fractions of this waste. GCD practices will include waste segregation, packaging, emplacement below the root zone, and stabilizing the emplacement with cement. Statistical review of SRP burial records showed that about 95% of the radioactivity is associated with only 5% of the waste volume. Trigger values determined in this study were compared with actual burials in 1982 to determine what GCD facilities would be needed for a demonstration to begin in Fall 1983. Facilities selected include 8-feet-diameter x 30-feet-deep boreholes to contain reactor scrap, tritiated waste, and selected wastes from offsite
Gino, Francesca; Wiltermuth, Scott S
We propose that dishonest and creative behavior have something in common: They both involve breaking rules. Because of this shared feature, creativity may lead to dishonesty (as shown in prior work), and dishonesty may lead to creativity (the hypothesis we tested in this research). In five experiments, participants had the opportunity to behave dishonestly by overreporting their performance on various tasks. They then completed one or more tasks designed to measure creativity. Those who cheated were subsequently more creative than noncheaters, even when we accounted for individual differences in their creative ability (Experiment 1). Using random assignment, we confirmed that acting dishonestly leads to greater creativity in subsequent tasks (Experiments 2 and 3). The link between dishonesty and creativity is explained by a heightened feeling of being unconstrained by rules, as indicated by both mediation (Experiment 4) and moderation (Experiment 5).
Arias Garcia, Rocio; Castro Gomez, Gustavo; Fallas Cordero, Kenneth; Grant Chaves, Samuel; Mendez Parrales, Tony; Parajeles Fernandez, Ivan
A study is conducted on different renewable energy within the larger metropolitan area, selecting the most suitable for the area and the implementation for distributed generation. A research methodology is practiced type pretending gather the necessary information to make proposals selected of different type of energy. The geography of the greater metropolitan area is studied along with the different existing renewable energy: distributed generation, remote measurement of energy which is one of the elements of the concept of intelligent networks (Smart Grid) in the electricity sector, legislation of Costa Rica regarding the generation of renewable energy and environmental impact. An analysis of economic feasibility is covered for each of the proposals estimating current rates for leading distributors of a future value, concluding with the viability of projects for possible execution of the same. (author) [es
Kimmel, T.B.; Smith, R.
'Full text:' A Hydrogen Village (H2V) is a public/private partnership with an objective to accelerate the commercialization of hydrogen and fuel cell technology in Canada and firmly position Canada as the international leader in this sector. The first Hydrogen Village is planned for the Greater Toronto Area (GTA) and will make use of existing hydrogen and fuel cell deployments to assist in its creation. This five year GTA Hydrogen Village program is planned to begin operations in 2004. The Hydrogen Village will demonstrate and deploy various hydrogen production and delivery techniques as well as fuel cells for stationary, transportation (mobile) and portable applications. This paper will provide an overview of the Hydrogen Village and identify the missions, objectives, members and progress within the H2V. (author)
Selmer, Jan; Lauring, Jakob; Feng, Yunxia
a positive impact on expatriates' job performance. Therefore, the purpose of this paper is toexamine the association between the age of business expatriates and their work performance in a Chinese cultural setting. Design/methodology/approach - Controlling for the potential bias of a number of background......, companies should not discriminate against older candidatesin expatriate selection for Greater China. Furthermore, older expatriates destined for a Chinesecultural context could be trained how to exploit their age advantage. Originality/value - In contrast to previous studies, this investigation attempts...... to match a certain personal characteristic of expatriates with a specific host culture. The results have implications for and contribute to the literature on expatriate selection as well as to the body of research on crosscultural training....
Johnson, Sherry A M; Gakuya, Daniel W; Mbuthia, Paul G; Mande, John D; Afakye, Kofi; Maingi, Ndichu
Myiasis is the infestation of tissues of live vertebrate animals and humans with dipterous larvae. In sub-Saharan Africa, Cordylobia anthropohaga and Cordylobia rodhaini are known to be responsible for cutaneous myiasis in animals and humans. Human cases of myiasis, purportedly acquired in Ghana but diagnosed in other countries, have been reported; however, published data on its occurrence in animals in Ghana is unavailable. This study assessed the prevalence of canine myiasis among owned dogs in the Greater Accra region (GAR) of Ghana. A cross-sectional study was conducted in the Greater Accra region of Ghana, selected for being the region with the highest estimated population density of owned dogs. Physical examination and demographic characteristics of the study dogs were assessed. Management of the dogs was assessed through a questionnaire administered to the dog owners. A total of 392 owned dogs were sampled. Twenty-nine (7.4%) had cutaneous myiasis caused by C. rodhaini. In addition, one (0.2%) of the dogs had intestinal myiasis, with Dermatobia hominis as the offending larvae. Among the breeds of dogs with myiasis, the mongrel was most affected, with 24 (82.8%) out of the 29 cases. The mongrels, majority of which (24; 82.8%) were males, were left to roam freely in the community. Results from this study demonstrate that C. rodhaini and D. hominis are important causes of myiasis in owned dogs in the GAR of Ghana. Dogs could play a role in the spread of myiasis to humans, with its attendant public health implications.
Full Text Available Globally, the responsible factors for the ongoing development of urbanization are the high speed of population growth, and the mass migration of humans to cities and large urban areas. In most countries, this process resulted in the emergence of ‘pseudo-urbanization’ which is difficult to be regulated. The purpose of the carried researches to determine the development priorities in the territory of Greater Baku – the capital city of the Republic of Azerbaijan; to define the problems that take place in this connection; and to develop ways of elimination of these problems. The reason of taking Baku as a research area is connected with some of the factors. Firstly, studies on Baku have been conducted based on the Soviet geographical and urban planning school and their methods for a long period. In this regard, it is necessary to carry out research in this field based on the principles adopted in most countries. Secondly, since 1992, the intensive accumulation of population in the territory of the capital city and the surrounding areas is being observed because of socio-economic problems. As a result, the process of pseudo-urbanization intensified, entailing a densely-populated area. Thirdly, low-rise buildings still continue to exist in the large areas within the territory of Baku, and they are not associated with the functional structure of the city. This situation creates many challenges, particularly in terms of density growth and effective use of the city’s territory. Finally, numerous new buildings have been constructed in the residential areas of Baku in recent years, and this may entailserious problems in water supply, energy provision, and utilities. The study is carried out referring to previous works of researchers, statistic data, and the results of the population census conducted in 1959-2009.The practical significance of the scientific work is that positive and negative factors affecting the further development of Greater Baku
Rafferty, Anna N; Griffiths, Thomas L; Ettlinger, Marc
Looking across human societies reveals regularities in the languages that people speak and the concepts that they use. One explanation that has been proposed for these "cultural universals" is differences in the ease with which people learn particular languages and concepts. A difference in learnability means that languages and concepts possessing a particular property are more likely to be accurately transmitted from one generation of learners to the next. Intuitively, this difference could allow languages and concepts that are more learnable to become more prevalent after multiple generations of cultural transmission. If this is the case, the prevalence of languages and concepts with particular properties can be explained simply by demonstrating empirically that they are more learnable. We evaluate this argument using mathematical analysis and behavioral experiments. Specifically, we provide two counter-examples that show how greater learnability need not result in a property becoming prevalent. First, more learnable languages and concepts can nonetheless be less likely to be produced spontaneously as a result of transmission failures. We simulated cultural transmission in the laboratory to show that this can occur for memory of distinctive items: these items are more likely to be remembered, but not generated spontaneously once they have been forgotten. Second, when there are many languages or concepts that lack the more learnable property, sheer numbers can swamp the benefit produced by greater learnability. We demonstrate this using a second series of experiments involving artificial language learning. Both of these counter-examples show that simply finding a learnability bias experimentally is not sufficient to explain why a particular property is prevalent in the languages or concepts used in human societies: explanations for cultural universals based on cultural transmission need to consider the full set of hypotheses a learner could entertain and all of
Full Text Available Startle eyeblink reflex is a valid non-invasive tool for studying attention, emotion and psychiatric disorders. In the absence of any experimental manipulation, the general (or baseline startle reflex shows a high inter-individual variability, which is often considered task-irrelevant and therefore normalized across participants. Unlike the above view, we hypothesized that greater general startle magnitude is related to participants’ higher anxiety level. 111 healthy young women, after completing the State-Trait Anxiety Inventory, were randomly administered 10 acoustic white noise probes (50 ms, 100 dBA acoustic level while integrated EMG from left and right orbicularis oculi was recorded. Results showed that participants with greater state anxiety levels exhibited larger startle reflex magnitude from the left eye (r109=0.23, p<0.05. Furthermore, individuals who perceived the acoustic probe as more aversive reported the largest anxiety scores (r109=0.28, p<0.05 and had the largest eyeblinks, especially in the left eye (r109 = 0.34, p<0.001. Results suggest that general startle may represent a valid tool for studying the neural excitability underlying anxiety and emotional dysfunction in neurological and mental disorders.
Kanji, Zul; Sunell, Susanne; Boschma, Geertje; Imai, Pauline; Craig, Bonnie J
There is little published literature about the outcomes of dental hygiene baccalaureate degree education, particularly in Canada. Since there are various dental hygiene entry-to-practice educational models in Canada, exploring baccalaureate dental hygiene education is becoming an increasingly important subject. The purpose of this study was to explore the personal outcomes and dental hygiene practice outcomes of dental hygiene degree-completion education in Canada from the perspectives of diploma dental hygienists who have continued their education to the bachelor's degree level. This study employed a qualitative phenomenological design, using a maximum variation purposeful sampling strategy. Data generation occurred with sixteen dental hygienists across Canada through individual semistructured interviews. Interviews were audiorecorded, transcribed verbatim, and coded for data analysis, involving pattern recognition and thematic development. Themes that emerged included changes in self-perception, values, and knowledge base. Changes in self-perception were reflected in a reported increase in self-confidence and perceived credibility. Changes in values included a greater appreciation for lifelong learning. Advancements in knowledge strengthened the development of specific abilities that ultimately influenced participants' dental hygiene practice. These abilities included an increased ability to think critically, to make evidence-based decisions, and to provide more comprehensive care. Participants also commented on having more career opportunities available to them outside of the private clinical practice setting. These results reveal important insights into the impact of earning a dental hygiene baccalaureate degree on oneself and one's dental hygiene practice.
Kristen L. Young
Full Text Available Objective – To explore student thought on both reflection and reflective writing as a process, and to analyze the writing by the application of clearly defined and identifiable outcomes.Design – Mixed method approach consisting of a qualitative analysis of 116 written reflections from master’s level students as well as a quantitative statistical analysis.Setting –The University of Sheffield masters-level librarianship program’s course INF6005, “Management for LIS.”Subjects – Of the 31 students registered the course during the 2007-2008 academic year, 22 (71%, allowed their reflections to be used for the purposes of research. Of these, 7 students identified themselves as male, and 15 were female. All students included were over 21 years of age and had previous library experience, with varying degrees of management experience in supervisory roles. Not all supervisory experience was gathered within the library domain.Methods –A total of 116 reflective journal entries were submitted by the participating students during the eight month period from October 2008 to May 2009. In order to identify themes, qualitative analysis was applied to the reflective writing responses. Descriptive statistics were also applied to test the hypothesis, illustrate the relationships between reflective writing and outcomes, and locate identifiable outcomes.Main Results – Practising reflection demonstrated benefits for individuals groups both in and outside of the workplace. On the whole, individuals gained the most from reflection and saw it in the most positive light when it was practised as a daily activity. Quantitatively, when students began to master the practice of reflection, they demonstrated an increase in their ability to learn and an overall improvement of self-development and critical thinking skills, and gained a defined awareness of personal mental function. When decision making became easier, students understood they had begun to master
Sides, Colby B; Enquist, Brian J; Ebersole, James J; Smith, Marielle N; Henderson, Amanda N; Sloat, Lindsey L
Darwin first proposed that species with larger ecological breadth have greater phenotypic variation. We tested this hypothesis by comparing intraspecific variation in specific leaf area (SLA) to species' local elevational range and by assessing how external (abiotic) filters may influence observed differences in ecological breadth among species. Understanding the patterns of individual variation within and between populations will help evaluate differing hypotheses for structuring of communities and distribution of species. We selected 21 species with varying elevational ranges and compared the coefficient of variation of SLA for each species against its local elevational range. We examined the influence of external filters on local trait composition by determining if intraspecific changes in SLA with elevation have the same direction and similar rates of change as the change in community mean SLA value. In support of Darwin's hypothesis, we found a positive relationship between species' coefficient of variation for SLA with species' local elevational range. Intraspecific changes in SLA had the same sign, but generally lower magnitude than the community mean SLA. The results indicate that wide-ranging species are indeed characterized by greater intraspecific variation and that species' phenotypes shift along environmental gradients in the same direction as the community phenotypes. However, across species, the rate of intraspecific trait change, reflecting plastic and/or adaptive changes across populations, is limited and prevents species from adjusting to environmental gradients as quickly as interspecific changes resulting from community assembly.
Doucet, Brian; Smit, Edske
Downtown Detroit has been undergoing a renaissance in recent years which is in stark contrast to the economic and social situation in much of the rest of the city. This renaissance has been taking place despite the city's ability to provide good municipal services such as streetlights, security, public space and transport. This article focuses on how four areas which constitute part of Greater Downtown Detroit have relied on different combinations of actors to create and provide the services and amenities deemed necessary for capital investment and middle-class consumption. Each area has its own initiatives and actors who implement them, further fragmenting the city between its core and periphery. Renewed public spaces, private police forces and resident initiatives in middle-class neighborhoods have been created to serve specific needs of the small areas they serve. Rather than being unique, Detroit is an extreme example of fragmented and polarized urbanism which is part and parcel of contemporary cities. We argue that rather than passively reflecting existing socio-spatial divides, these private initiatives in Greater Downtown Detroit actively contribute to the production of sociospatial inequalities across the city.
Full Text Available Confidence that randomized controlled trial (RCT results accurately reflect intervention effectiveness depends on proper trial conduct and the accuracy and completeness of published trial reports. The Journal of Consulting and Clinical Psychology (JCCP is the primary trials journal amongst American Psychological Association (APA journals. The objectives of this study were to review RCTs recently published in JCCP to evaluate (1 adequacy of primary outcome analysis definitions; (2 registration status; and, (3 among registered trials, adequacy of outcome registrations. Additionally, we compared results from JCCP to findings from a recent study of top psychosomatic and behavioral medicine journals.Eligible RCTs were published in JCCP in 2013-2014. For each RCT, two investigators independently extracted data on (1 adequacy of outcome analysis definitions in the published report, (2 whether the RCT was registered prior to enrolling patients, and (3 adequacy of outcome registration.Of 70 RCTs reviewed, 12 (17.1% adequately defined primary or secondary outcome analyses, whereas 58 (82.3% had multiple primary outcome analyses without statistical adjustment or undefined outcome analyses. There were 39 (55.7% registered trials. Only two trials registered prior to patient enrollment with a single primary outcome variable and time point of assessment. However, in one of the two trials, registered and published outcomes were discrepant. No studies were adequately registered as per Standard Protocol Items: Recommendation for Interventional Trials guidelines. Compared to psychosomatic and behavioral medicine journals, the proportion of published trials with adequate outcome analysis declarations was significantly lower in JCCP (17.1% versus 32.9%; p = 0.029. The proportion of registered trials in JCCP (55.7% was comparable to behavioral medicine journals (52.6%; p = 0.709.The quality of published outcome analysis definitions and trial registrations in JCCP is
Azar, Marleine; Riehm, Kira E; McKay, Dean; Thombs, Brett D
Confidence that randomized controlled trial (RCT) results accurately reflect intervention effectiveness depends on proper trial conduct and the accuracy and completeness of published trial reports. The Journal of Consulting and Clinical Psychology (JCCP) is the primary trials journal amongst American Psychological Association (APA) journals. The objectives of this study were to review RCTs recently published in JCCP to evaluate (1) adequacy of primary outcome analysis definitions; (2) registration status; and, (3) among registered trials, adequacy of outcome registrations. Additionally, we compared results from JCCP to findings from a recent study of top psychosomatic and behavioral medicine journals. Eligible RCTs were published in JCCP in 2013-2014. For each RCT, two investigators independently extracted data on (1) adequacy of outcome analysis definitions in the published report, (2) whether the RCT was registered prior to enrolling patients, and (3) adequacy of outcome registration. Of 70 RCTs reviewed, 12 (17.1%) adequately defined primary or secondary outcome analyses, whereas 58 (82.3%) had multiple primary outcome analyses without statistical adjustment or undefined outcome analyses. There were 39 (55.7%) registered trials. Only two trials registered prior to patient enrollment with a single primary outcome variable and time point of assessment. However, in one of the two trials, registered and published outcomes were discrepant. No studies were adequately registered as per Standard Protocol Items: Recommendation for Interventional Trials guidelines. Compared to psychosomatic and behavioral medicine journals, the proportion of published trials with adequate outcome analysis declarations was significantly lower in JCCP (17.1% versus 32.9%; p = 0.029). The proportion of registered trials in JCCP (55.7%) was comparable to behavioral medicine journals (52.6%; p = 0.709). The quality of published outcome analysis definitions and trial registrations in JCCP is
A new analysis of Energy Department medical records has found higher than expected cancer rates among workers at DOE's Hanford nuclear weapons plant, suggesting occupational exposure to low-level radiation may be more dangerous than previously thought. The study, released Tuesday by the Philadelphia-based Three Mile Island Public Health Fund, is important not only because of its controversial conclusions, but also because it represents the first independent review of DOE's long-secret worker medical records. The new study done by Stewart and Kneale looked at Hanford worker health records dating up to 1986 - part of a huge trove of data withheld by DOE from independent researchers until two years ago. In their re-analysis of the Hanford worker records, Stewart and Kneale found increased cancer rates among older workers who were over 40 years of age when exposed. And they said that increased susceptibility of older people to radiation-induced cancer was not reflected in the highly influential Japanese atomic bomb studies because people over 50 years of age were open-quotes grossly under-representedclose quotes in the A-bomb analyses, possibly because many bomb victims suffered early deaths from high doses
Baker, Dirk E.; van der Neut, Cornelis A.
A swept-frequency interferometer is described for making rapid, real-time assessments of localized inhomogeneities in planar microwave absorber panels. An aperture-matched exponential horn is used to reduce residual reflections in the system to about -37 dB. This residual reflection is adequate for making comparative measurements on planar absorber panels whose reflectivities usually fall in the -15 to -25 dB range. Reflectivity measurements on a variety of planar absorber panels show that multilayer Jaumann absorbers have the greatest inhomogeneity, while honeycomb absorbers generally have excellent homogeneity within a sheet and from sheet to sheet. The test setup is also used to measure the center frequencies of resonant absorbers. With directional couplers and aperture-matched exponential horns, the technique can be easily applied in the standard 2 to 40 GHz waveguide bands.
Fr. Prof. Asouzu
Glossary of Igbo Terms and Phrases ihe ahụ na anya ... other words, it is in mutual dependence that the feeling of intimacy found among kindred ..... Complementary Reflection, Communalism and Theory Formulation in African Philosophy 25.
National Oceanic and Atmospheric Administration, Department of Commerce — NGDC maintains a large volume of both Analog and Digital seismic reflection data. Currently only a limited number of lines are available online. Digital data include...
Templeton, Ronald K.; Siefert, Thomas E.
Offers a variety of specific techniques which will help the beginning teacher to implement reflective methodology and create an inquiry-centered classroom atmosphere, at the same time meeting the many more pressing demands of first-year teaching. (JES)
In this article some recent developments in selective reflection spectroscopy is reviewed and the various ways to extend Doppler free techniques to this spectroscopic field is discussed. Its main feature is to probe atomic gas close to the cell boundaries
Stein, R.S.; Toda, S.; Parsons, T.; Grunewald, E.; Blong, R.; Sparks, S.; Shah, H.; Kennedy, J.
Tokyo and its outlying cities are home to one-quarter of Japan's 127 million people. Highly destructive earthquakes struck the capital in 1703, 1855 and 1923, the last of which took 105 000 lives. Fuelled by greater Tokyo's rich seismological record, but challenged by its magnificent complexity, our joint Japanese-US group carried out a new study of the capital's earthquake hazards. We used the prehistoric record of great earthquakes preserved by uplifted marine terraces and tsunami deposits (17 M???8 shocks in the past 7000 years), a newly digitized dataset of historical shaking (10 000 observations in the past 400 years), the dense modern seismic network (300 000 earthquakes in the past 30 years), and Japan's GeoNet array (150 GPS vectors in the past 10 years) to reinterpret the tectonic structure, identify active faults and their slip rates and estimate their earthquake frequency. We propose that a dislodged fragment of the Pacific plate is jammed between the Pacific, Philippine Sea and Eurasian plates beneath the Kanto plain on which Tokyo sits. We suggest that the Kanto fragment controls much of Tokyo's seismic behaviour for large earthquakes, including the damaging 1855 M???7.3 Ansei-Edo shock. On the basis of the frequency of earthquakes beneath greater Tokyo, events with magnitude and location similar to the M??? 7.3 Ansei-Edo event have a ca 20% likelihood in an average 30 year period. In contrast, our renewal (time-dependent) probability for the great M??? 7.9 plate boundary shocks such as struck in 1923 and 1703 is 0.5% for the next 30 years, with a time-averaged 30 year probability of ca 10%. The resulting net likelihood for severe shaking (ca 0.9g peak ground acceleration (PGA)) in Tokyo, Kawasaki and Yokohama for the next 30 years is ca 30%. The long historical record in Kanto also affords a rare opportunity to calculate the probability of shaking in an alternative manner exclusively from intensity observations. This approach permits robust estimates
Jensen, Karsten Klint; Forsberg, Ellen-Marie; Gamborg, Christian
Several studies have indicated that scientists are likely to have an outlook on both facts and values that are different to that of lay people in important ways. This is one significant reason it is currently believed that in order for scientists to exercise a reliable ethical reflection about...... their research it is necessary for them to engage in dialogue with other stakeholders. This paper reports on an exercise to encourage a group of scientists to reflect on ethical issues without the presence of external stakeholders. It reports on the use of a reflection process with scientists working in the area...... of animal disease genomics (mainly drawn from the EADGENE EC Network of Excellence). This reflection process was facilitated by using an ethical engagement framework, a modified version of the Ethical Matrix. As judged by two criteria, a qualitative assessment of the outcomes and the participants' own...
Lasater, Kathie; Nielsen, Ann
Reflective journaling is a strategy used often in clinical education to gain insight into students' clinical thinking; however, studies indicate that students may benefit from guided reflections. Numerous tools have been used to structure student reflection with varying results. This article describes the outcomes from using the Guide for Reflection based on Tanner's Clinical Judgment Model. The Lasater Clinical Judgment Rubric, created from the Model, is used to evaluate development of clinical judgment and provides language to communicate about clinical thinking with students. Senior immersion course competencies, also developed with language from Tanner's Clinical Judgment Model,offer a comprehensive package that fosters students' clinical judgment development, faculty-student communication about clinical judgment, and evaluation of students' clinical thinking.
Hu, L.; Fan, W.; Liu, S.; Ren, H.; Xu, X.
GPP (Gross Primary Productivity) is an important index to reflect the productivity of plants because it refers to the organic accumulated by green plants on land through assimilating the carbon dioxide in the atmosphere by photosynthesis and a serial of physiological processes in plants. Therefore, GPP plays a significant role in studying the carbon sink of terrestrial ecosystem and plants' reaction to global climate change. Remote sensing provides an efficient way to estimate GPP at regional and global scales and its products can be used to monitor the spatiotemporal variation of terrestrial ecosystem.As the Greater Khingan Mountains is the only bright coniferous forest of cool temperate zone in China and accounts for about 30% of the forest in China. This region is sensitive to climate change, but its forest coverage presented a significant variation due to fire disasters, excessive deforestation and so on. Here, we aimed at studying the variation pattern of GPP in the Greater Khingan Mountains and further found impact factors for the change in order to improve the understanding of what have and will happen on plants and carbon cycle under climate change.Based on GPP product from the GLASS program, we first studied spatial distribution of plants in the Greater Khingan Mountains from 1982 to 2015. With a linear regression model, seasonal and inter-annual GPP variability were explored on pixel and regional scale. We analyzed some climatic factors (e.g. temperature and precipitation) and terrain in order to find the driven factors for the GPP variations. The Growing Season Length (GSL) was also regarded as a factor and was retrieved from GIMMS 3g NDVI datasets using dynamic threshold method. We found that GPP in study area linearly decreased with the increasing elevation. Both annual accumulated GPP (AAG) and maximum daily GPP (during mid-June to mid-July) gained obvious improvement over the past 34 years under climate warming and drying (Fig.1 and Fig.2). Further
Pendleton, Y.; Werner, M.W.; Capps, R.; Lester, D.; Hawaii Univ., Honolulu; Texas Univ., Austin)
New observations of Orion Molecular Cloud 2 have been made from 1 to 100 microns using the NASA Infrared Telescope Facility and the Kuiper Airborne Observatory. An extensive program of polarimetry, photometry, and spectrophotometry has shown that the extended emission regions associated with two of the previously known near-infrared sources, IRS 1 and IRS 4, are infrared reflection nebulae, and that the compact sources IRS 1 and IRS 4 are the main luminosity sources in the cloud. The constraints from the far-infrared observations and an analysis of the scattered light from the IRS 1 nebula show that OMC-2/IRS 1 can be characterized by L of 500 solar luminosities or less and T of roughly 1000 K. The near-infrared albedo of the grains in the IRS 1 nebula is greater than 0.08. 27 references
Haggard, Hal M.; Cowan, Nicolas B.
The disk-integrated reflected brightness of an exoplanet changes as a function of time due to orbital and rotational motion coupled with an inhomogeneous albedo map. We have previously derived analytic reflected lightcurves for spherical harmonic albedo maps in the special case of a synchronously-rotating planet on an edge-on orbit (Cowan, Fuentes & Haggard 2013). In this letter, we present analytic reflected lightcurves for the general case of a planet on an inclined orbit, with arbitrary spin period and non-zero obliquity. We do so for two different albedo basis maps: bright points (δ-maps), and spherical harmonics (Y_l^m-maps). In particular, we use Wigner D-matrices to express an harmonic lightcurve for an arbitrary viewing geometry as a non-linear combination of harmonic lightcurves for the simpler edge-on, synchronously rotating geometry. These solutions will enable future exploration of the degeneracies and information content of reflected lightcurves, as well as fast calculation of lightcurves for mapping exoplanets based on time-resolved photometry. To these ends we make available Exoplanet Analytic Reflected Lightcurves (EARL), a simple open-source code that allows rapid computation of reflected lightcurves.
Batty, M.; Carvalho, R.; Hudson-Smith, A.; Milton, R.; Smith, D.; Steadman, P.
Many aggregate distributions of urban activities such as city sizes reveal scaling but hardly any work exists on the properties of spatial distributions within individual cities, notwithstanding considerable knowledge about their fractal structure. We redress this here by examining scaling relationships in a world city using data on the geometric properties of individual buildings. We first summarise how power laws can be used to approximate the size distributions of buildings, in analogy to city-size distributions which have been widely studied as rank-size and lognormal distributions following Zipf [ Human Behavior and the Principle of Least Effort (Addison-Wesley, Cambridge, 1949)] and Gibrat [ Les Inégalités Économiques (Librarie du Recueil Sirey, Paris, 1931)]. We then extend this analysis to allometric relationships between buildings in terms of their different geometric size properties. We present some preliminary analysis of building heights from the Emporis database which suggests very strong scaling in world cities. The data base for Greater London is then introduced from which we extract 3.6 million buildings whose scaling properties we explore. We examine key allometric relationships between these different properties illustrating how building shape changes according to size, and we extend this analysis to the classification of buildings according to land use types. We conclude with an analysis of two-point correlation functions of building geometries which supports our non-spatial analysis of scaling.
Hardin, J.W.; Gilbert, R.O.
The Washington State Department of Ecology (WSDE) recently issued a report that provides guidance on statistical issues regarding investigation and cleanup of soil and groundwater contamination under the Model Toxics Control Act Cleanup Regulation. Included in the report are procedures for determining a background-based cleanup standard and for conducting a 3-step statistical test procedure to decide if a site is contaminated greater than the background standard. The guidance specifies that the State test should only be used if the background and site data are lognormally distributed. The guidance in WSDE allows for using alternative tests on a site-specific basis if prior approval is obtained from WSDE. This report presents the results of a Monte Carlo computer simulation study conducted to evaluate the performance of the State test and several alternative tests for various contamination scenarios (background and site data distributions). The primary test performance criteria are (1) the probability the test will indicate that a contaminated site is indeed contaminated, and (2) the probability that the test will indicate an uncontaminated site is contaminated. The simulation study was conducted assuming the background concentrations were from lognormal or Weibull distributions. The site data were drawn from distributions selected to represent various contamination scenarios. The statistical tests studied are the State test, t test, Satterthwaite's t test, five distribution-free tests, and several tandem tests (wherein two or more tests are conducted using the same data set)
Schwartz, C.C.; Haroldson, M.A.; Gunther, K.; Moody, D.
The US Fish and Wildlife Service (USFWS) proposed delisting the Yellowstone grizzly bear (Ursus arctos horribilis) in November 2005. Part of that process required knowledge of the most current distribution of the species. Here, we update an earlier estimate of occupied range (1990–2000) with data through 2004. We used kernel estimators to develop distribution maps of occupied habitats based on initial sightings of unduplicated females (n = 481) with cubs of the year, locations of radiomarked bears (n = 170), and spatially unique locations of conflicts, confrontations, and mortalities (n = 1,075). Although each data set was constrained by potential sampling bias, together they provided insight into areas in the Greater Yellowstone Ecosystem (GYE) currently occupied by grizzly bears. The current distribution of 37,258 km2 (1990–2004) extends beyond the distribution map generated with data from 1990–2000 (34,416 km2 ). Range expansion is particularly evident in parts of the Caribou–Targhee National Forest in Idaho and north of Spanish Peaks on the Gallatin National Forest in Montana.
Billings, C.D.; Ziemke, M.C.; Stanford, R.
Recent events have focused attention on the promotion of greater utilization of biomass fuel. Considerations include the need to reduce increases in global warming and also to improve ground level air quality by limiting the use of fossil fuels. However, despite all these important environmentally related considerations, economics remains the most important factor in the decision process used to determine the feasibility of using available renewable fuels instead of more convenient fossil fuels. In many areas of the Southeast, this decision process involves choosing between wood residue fuels such as bark, sawdust and shavings and presently plentiful natural gas. The primary candidate users of wood residue fuels are industries that use large amounts of heat and electric power and are located near centers of activity in the forest products industry such as sawmills, veneer mills and furniture factories. Given that such facilities both produce wood residues and need large amounts of heat and electricity, it is understandable that these firms are often major users of wood-fired furnaces and boilers. The authors have observed that poor or incomplete financial planning by the subject firms is a major barrier to economic utilization of inexpensive and widely available renewable fuels. In this paper, the authors suggest that wider usage of improved financial planning could double the present modest annual incidence of new commercial wood-fueled installation
Patient identification errors in pre-transfusion blood sampling ('wrong blood in tube') are a persistent area of risk. These errors can potentially result in life-threatening complications. Current measures to address root causes of incidents and near misses have not resolved this problem and there is a need to look afresh at this issue. PROJECT PURPOSE: This narrative review of the literature is part of a wider system-improvement project designed to explore and seek a better understanding of the factors that contribute to transfusion sampling error as a prerequisite to examining current and potential approaches to error reduction. A broad search of the literature was undertaken to identify themes relating to this phenomenon. KEY DISCOVERIES: Two key themes emerged from the literature. Firstly, despite multi-faceted causes of error, the consistent element is the ever-present potential for human error. Secondly, current focus on error prevention could potentially be augmented with greater attention to error recovery. Exploring ways in which clinical staff taking samples might learn how to better identify their own errors is proposed to add to current safety initiatives.
Leppäkoski, Tuija Helena; Flinck, Aune; Paavilainen, Eija
Domestic violence (DV) is a major public health problem with high health and social costs. A solution to this multi-faceted problem requires that various help providers work together in an effective and optimal manner when dealing with different parties of DV. The objective of our research and development project (2008-2013) was to improve the preparedness of the social and healthcare professionals to manage DV. This article focuses on the evaluation of interprofessional education (IPE) to provide knowledge and skills for identifying and intervening in DV and to improve collaboration among social and health care professionals and other help providers at the local and regional level. The evaluation data were carried out with an internal evaluation. The evaluation data were collected from the participants orally and in the written form. The participants were satisfied with the content of the IPE programme itself and the teaching methods used. Participation in the training sessions could have been more active. Moreover, some of the people who had enrolled for the trainings could not attend all of them. IPE is a valuable way to develop intervening in DV. However, greater commitment to the training is required from not only the participants and their superiors but also from trustees.
Towler, O.A.; Cook, J.R.; Peterson, D.L.; Reddick, J.A.
A facility to demonstrate Greater Confinement Disposal (GCD) of low-level solid radioactive waste in a humid environment has been built and is operating at the Savannah River Plant (SRP). GCD practices of waste segregation into high and low activity concentrations, emplacement of waste below the root zone, waste stabilization, and capping are being used in the demonstration. Activity concentrations to select wastes for GCD are based on the volume/activity distribution of low-level solid wastes as obtained from SRP burial records, and are equal to or less than those for Class B waste in 10 CFR 61. The first disposal units constructed are twenty 9-ft-diam, 30-ft-deep boreholes. These holes will be used to dispose of wastes from the production reactors, tritiated wastes, and selected wastes from offsite. In 1984, construction will begin on an engineered GCD trench for disposal of boxed waste and large bulky items that meet the activity concentration criteria. 4 references, 5 figures, 2 tables
Brown, Patrick T; Caldeira, Ken
Climate models provide the principal means of projecting global warming over the remainder of the twenty-first century but modelled estimates of warming vary by a factor of approximately two even under the same radiative forcing scenarios. Across-model relationships between currently observable attributes of the climate system and the simulated magnitude of future warming have the potential to inform projections. Here we show that robust across-model relationships exist between the global spatial patterns of several fundamental attributes of Earth's top-of-atmosphere energy budget and the magnitude of projected global warming. When we constrain the model projections with observations, we obtain greater means and narrower ranges of future global warming across the major radiative forcing scenarios, in general. In particular, we find that the observationally informed warming projection for the end of the twenty-first century for the steepest radiative forcing scenario is about 15 per cent warmer (+0.5 degrees Celsius) with a reduction of about a third in the two-standard-deviation spread (-1.2 degrees Celsius) relative to the raw model projections reported by the Intergovernmental Panel on Climate Change. Our results suggest that achieving any given global temperature stabilization target will require steeper greenhouse gas emissions reductions than previously calculated.
Valenzuela, M S; Herold, J M; Morris, L; López, I M
In 1988 a survey was carried out in order to obtain information on knowledge about reproduction, sexual activity, attitudes, and use of contraceptive methods among residents between 15 and 24 years of age in Greater Santiago. For this purpose, a multistage, self-weighted, non-replacement probability sample was chosen from the entire Santiago urban area. After 2,898 households were visited, 865 women and 800 men were selected and interviewed. For the interview, a questionnaire with 156 questions was developed; many questions were similar to those included in similar surveys in Brazil and Guatemala. The interviewers were professionals who had received prior training. Although 75% of the interviewees had attended sex education classes, they had erroneous ideas on various basic subjects. Sixty-nine percent of the women interviewed had undergone menarche before attending these classes. In addition, 35.4% of the women and 65.0% of the men had had sexual relations prior to marriage, and less than 20% had used any contraceptive method. More than 60% of the interviewees who had children had conceived them before marrying. These findings point up the necessity of offering sex education classes for children and young people, as well as facilitating their access to family planning services, in order to decrease the number of illegitimate and unwanted children that are born in Chile.
Full Text Available The Greater Toronto Area (GTA is one of the most multicultural communities in the world. Frequently, this description is based on ethnic, linguistic, and culinary diversity. Physical cultural diversity, such as different sports, martial arts, forms of dance, exercise systems, and other physical games and activities, remains ignored and understudied. Based on a living database of the GTA’s physical cultural diversity, this study identifies the trajectories of the lifecycle of activities that have been introduced into the GTA’s physical culture by immigrants. These pathways differ based on whether the activity is offered in a separate setting, where individuals may be participating with other immigrants of the same ethnocultural group, or mixed settings, where people are participating with people from outside of their ethnocultural group. We argue that the diversity and the lifecycle trajectories of physical cultural forms in the GTA serve as evidence of interculturalism and the contribution by immigrants to the social and cultural life of Canada.
Full Text Available Abstract Background There is fMRI evidence that women are neurally predisposed to process infant laughter and crying. Other findings show that women might be more empathic and sensitive than men to emotional facial expressions. However, no gender difference in the brain responses to persons and unanimated scenes has hitherto been demonstrated. Results Twenty-four men and women viewed 220 images portraying persons or landscapes and ERPs were recorded from 128 sites. In women, but not in men, the N2 component (210–270 was much larger to persons than to scenes. swLORETA showed significant bilateral activation of FG (BA19/37 in both genders when viewing persons as opposed to scenes. Only women showed a source of activity in the STG and in the right MOG (extra-striate body area, EBA, and only men in the left parahippocampal area (PPA. Conclusion A significant gender difference was found in activation of the left and right STG (BA22 and the cingulate cortex for the subtractive condition women minus men, thus indicating that women might have a greater preference or interest for social stimuli (faces and persons.
Because lighter chemical feedstocks such as propylene and butylenes are more reactive than LPG's they pose a greater risk of vapor cloud explosion, particularly during their transport. According to C.S. Windebank (Insurance Tech. Bur.), percussive unconfined vapor cloud explosions (PUVCE's) do not usually occur below the ten-ton threshold for saturated hydrocarbons but can occur well below this threshold in the case of unsaturated hydrocarbons such as propylene and butylenes. Boiling liquid expanding vapor explosions (BLEVE's) are more likely to be ''hot'' (i.e., the original explosion is associated with fire) than ''cold'' in the case of unsaturated hydrocarbons. No PUVCE or BLEVE incident has been reported in the UK. In the US, 16 out of 20 incidents recorded between 1970 and 1975 were related to chemical feedstocks, including propylene and butylenes, and only 4 were LPG-related. The average losses were $20 million per explosion. Between 1968 and 1978, 8% of LPG pipeline spillages led to explosions.
The Department of Energy (DOE) has developed a plan for the management and disposal of commercially generated greater-than-Class C (GTCC) low-level radioactive waste. The Low-Level Radioactive Waste Policy Amendments Act of 1985 made DOE responsible for disposal of GTCC waste. The act requires that GTCC waste be disposed in a Nuclear Regulatory Commission (NRC)-licensed facility. The NRC has amended 10 CFR 61 to express a preference for geologic disposal of GTCC waste. Based on reassessment studies, legislative guidance, and stakeholder involvement, a revised plan has been formulated to provide for total management of GTCC waste. The plan has four major thrusts: (1) plan for GTCC waste storage at the generator site until disposal is available, (2) establish storage for GTCC sealed sources posing health and safety risk to the public, (3) facilitate storage for other GTCC waste posing health and safety risk to the public, and (4) plan for co-disposal of GTCC waste in a geologic disposal site with similar waste types. The revised plan focuses on applying available resources to near- and long-term needs.
Gozalo, Alfonso S; Schwiebert, Rebecca S; Metzner, Walter; Lawson, Gregory W
During a routine 6-month quarantine period, 3 of 34 greater horseshoe bats (Rhinolophus ferrumequinum) captured in mainland China and transported to the United States for use in echolocation studies were found dead with no prior history of illness. All animals were in good body condition at the time of death. At necropsy, a large amount of white fat was found within the subcutis, especially in the sacrolumbar region. The liver, kidneys, and heart were diffusely tan in color. Microscopic examination revealed that hepatocytes throughout the liver were filled with lipid, and in some areas, lipid granulomas were present. renal lesions included moderate amounts of lipid in the cortical tubular epithelium and large amounts of protein and lipid within Bowman's capsules in the glomeruli. In addition, one bat had large lipid vacuoles diffusely distributed throughout the myocardium. The exact pathologic mechanism inducing the hepatic, renal, and cardiac lipidosis is unknown. The horseshoe bats were captured during hibernation and immediately transported to the United States. It is possible that the large amount of fat stored coupled with changes in photoperiod, lack of exercise, and/or the stress of captivity might have contributed to altering the normal metabolic processes, leading to anorexia and consequently lipidosis in these animals.
Crosby, J.; Singh, I.; Reil, D. D.; Neden, G.
To improve the overall quality of the treated water delivered to the member municipalities of the Greater Vancouver Water District (GVWD), the GVWD implemented a phased drinking water quality improvement program. The phased treatment program is directed at attaining effective disinfection while minimizing the formation of chlorinated disinfection by-products. Accordingly, the current primary disinfection method of chlorination was reevaluated and an ozone primary disinfection without filtration was authorized. Ozonization provides increased protection against Giardia and Cryptosporidium and a decrease in the formation potential for disinfection by-products (DPBs). This paper describes the design for the ozonation facility at Coquitlam, construction of which began in 1998 and completed during the summer of 2000. The facility houses the liquid oxygen supply, ozone generation, cooling water, ozone injection, primary off-gas ozone destruct system, and provides a home for various office, electrical maintenance and diesel generating functions. The second site at Capilano is expected to start construction in the fall of 2000 and be completed late in 2002. Wit its kilometre long stainless steel ozone contactor and sidestream injector tower, the Coquitlam Ozonation Facility is the first ozone pressure injection system of its kind in North America. 1 tab., 2 figs.
Full Text Available This paper is concerned with the interaction between fully and boundedly rational agents in situations where their interests are perfectly aligned. The cognitive limitations of the boundedly rational agent do not allow him to fully understand the market conditions and lead him to take non-optimal decisions in some situations. Using categorization to model bounded rationality, we show that the fully rational agent can nudge, i.e., he can manipulate the information he sends and decrease the expected loss caused by the boundedly rational agent. Assuming different types for the boundedly rational agent, who differ only in the categories used, we show that the fully rational agent may learn the type of the boundedly rational agent along their interaction. Using this additional information, the outcome can be improved and the amount of manipulated information can be decreased. Furthermore, as the length of the interaction increases the probability that the fully rational agent learns the type of the boundedly rational agent grows
Full Text Available OBJECTIVE: To analyze how scrotal neoplasias have been managed during the past decade and to question possible factors or professions associated to its presence. MATERIALS AND METHODS: We retrospectively evaluated every case reported from 1995 to 2005 at our hospital. We described the clinical scenario, complementary exams, treatments and outcomes. We also tried to verify if there was any risk, predisposing factors or professions that would explain the cancer origin. RESULTS: Six cases were reviewed. Out of these, three patients were truck drivers. Five of them showed restricted lesions without inguinal lymph nodes enlargement. Histologically, six patients presented squamous carcinoma, with two of them having the verrucous type. The median age of patients was 52 years old (31 to 89. The five patients who are still alive had their lesions completely removed with safety margin and primary closure. CONCLUSIONS: We have noticed that the scrotal carcinoma behavior is similar to that of the penis, where removal of the lesion and study of the regional lymph nodes help to increase the patient survival rate. The outstanding fact was that three out of six patients were truck drivers, raising the hypothesis that such profession, maybe due to the contact or attrition with the diesel exhaust expelled by the engine or to sexual promiscuity, would imply in a larger risk of developing this rare neoplasia.
Full Text Available Electricity is a vital factor underlying modern living standards, but there are many developing countries with low levels of electricity access and use. We seek to systematically identify the crucial elements underlying transitions toward greater electrification in developing countries. We use a cross-sectional regression approach with national-level data up to 2012 for 135 low- and middle-income countries. The paper finds that the effectiveness of governments is the most important governance attribute for encouraging the transition to increased electrification in developing countries, on average. The results add to the growing evidence on the importance of governance for development outcomes. Donors seeking to make more successful contributions to electrification may wish to target countries with more effective governments.
Thomas, Elizabeth A; Mcnair, Bryan; Bechtell, Jamie L; Ferland, Annie; Cornier, Marc-Andre; Eckel, Robert H
Phentermine is thought to cause weight loss through a reduction in hunger. It was hypothesized that higher hunger ratings would predict greater weight loss with phentermine. This is an observational pilot study in which all subjects were treated with phentermine for 8 weeks and appetite and eating behaviors were measured at baseline and week 8. Outcomes were compared in subjects with ≥5% vs. hunger (P = 0.017), desire to eat (P =0.003), and prospective food consumption (0.006) and lower baseline cognitive restraint (P = 0.01). In addition, higher baseline home prospective food consumption (P = 0.002) and lower baseline cognitive restraint (P hunger and less restraint are more likely to achieve significant weight loss with phentermine. This information can be used clinically to determine who might benefit most from phentermine treatment. © 2015 The Obesity Society.
Full Text Available To assess prevalence and associated factors of myopia and high myopia in schoolchildren in Greater Beijing.The school-based, cross-sectional Greater Beijing School Children Myopia study was carried out in the year 2016 in 54 schools randomly selected from 15 districts in Beijing. Non-cycloplegic auto-refractometry of the right eyes was performed.The study included 35,745 (99.4% out of 35,968 eligible pupils with a mean age of 12.6±3.4 years (range 6-18 years. Prevalence of myopia defined as myopic refractive error of ≥-0.50 diopters (D,≥-1D,≥-6D,≥-8D and ≥-10D was 70.9%(95% confidence intervals (CI:70.5,71.4, 60.9% (95%CI:60.4,61.4, 8.6%(95%CI:8.4,8.9, 2.2%(95%CI:2.0,2.4, and 0.3% (95%CI:0.3,0.4, respectively. The frequency of high myopia (≥-6D, ≥-8D, ≥-10D increased from 1.5% (95%CI:1.0,2.0, 0.4% (95%CI:0.1,0.6 and 0.1% (95%CI:0.00,0.02, respectively in 10-year-olds to 19.4% (95%CI:17.3,21.6, 5.2% (95%CI:4.0,6.4 and 0.9% (95%CI:0.4,1.5, respectively, in 18-year-olds. Mean refractive error in the 18-year-olds was -3.74±2.56D (median:-3.63D;range:-19.6D to + 6.25D. Higher prevalence of high myopia (≥-6D and ≥-8D was correlated (all P<0.001 with older age (OR:1.18, and 1.15, respectively, female gender (OR: 1.44 and 1.40, respectively, higher body mass index (OR: 1.02 and 1.03, respectively, taller body height (OR: 1.03 and 1.02, respectively, urban region of habitation (OR: 1.26 and 1.33, respectively and higher school type (OR:1.57 and 2.22, respectively. Prevalence of severe high myopia (≥-10D was associated only with older age (P<0.001; OR: 1.44; 95%CI: 1.31, 1.59 but not with any education-related parameter such as higher school type (P = 0.48, urban region of habitation (P = 0.07 or female gender (P = 0.37.In this most recent survey, prevalence of high myopia (≥-6D:19.4%;≥-8D:5.2%;≥-10D:0.9% in 18-year-old school children was higher than in previous surveys from mainland China. In contrast to minor high myopia
Amy E. Pinkham; Philip D. Harvey; David L. Penn
Paranoia is a common symptom of schizophrenia that may be related to how individuals process and respond to social stimuli. Previous investigations support a link between increased paranoia and greater social cognitive impairments, but these studies have been limited to single domains of social cognition, and no studies have examined how paranoia may influence functional outcome. Data from 147 individuals with schizophrenia were used to examine whether actively paranoid and non-paranoid indiv...
Gunther, Kerry A.; Shoemaker, Rebecca; Frey, Kevin L.; Haroldson, Mark A.; Cain, Steven L.; van Manen, Frank T.; Fortin, Jennifer K.
Grizzly bears (Ursus arctos) in the Greater Yellowstone Ecosystem (GYE) are opportunistic omnivores that eat a great diversity of plant and animal species. Changes in climate may affect regional vegetation, hydrology, insects, and fire regimes, likely influencing the abundance, range, and elevational distribution of the plants and animals consumed by GYE grizzly bears. Determining the dietary breadth of grizzly bears is important to document future changes in food resources and how those changes may affect the nutritional ecology of grizzlies. However, no synthesis exists of all foods consumed by grizzly bears in the GYE. We conducted a review of available literature and compiled a list of species consumed by grizzly bears in the GYE. We documented >266 species within 200 genera from 4 kingdoms, including 175 plant, 37 invertebrate, 34 mammal, 7 fungi, 7 bird, 4 fish, 1 amphibian, and 1 algae species as well as 1 soil type consumed by grizzly bears. The average energy values of the ungulates (6.8 kcal/g), trout (Oncorhynchus spp., 6.1 kcal/g), and small mammals (4.5 kcal/g) eaten by grizzlies were higher than those of the plants (3.0 kcal/g) and invertebrates (2.7 kcal/g) they consumed. The most frequently detected diet items were graminoids, ants (Formicidae), whitebark pine seeds (Pinus albicaulis), clover (Trifolium spp.), and dandelion (Taraxacum spp.). The most consistently used foods on a temporal basis were graminoids, ants, whitebark pine seeds, clover, elk (Cervus elaphus), thistle (Cirsium spp.), and horsetail (Equisetum spp.). Historically, garbage was a significant diet item for grizzlies until refuse dumps were closed. Use of forbs increased after garbage was no longer readily available. The list of foods we compiled will help managers of grizzly bears and their habitat document future changes in grizzly bear food habits and how bears respond to changing food resources.
Ngaina, J. N.
The El Nino-Southern Oscillation (ENSO) is a primary mode of climate variability in the Greater of Africa (GHA). The expected impacts of climate variability and change on water, agriculture, and food resources in GHA underscore the importance of reliable and accurate seasonal climate predictions. The study evaluated different model selection criteria which included the Coefficient of determination (R2), Akaike's Information Criterion (AIC), Bayesian Information Criterion (BIC), and the Fisher information approximation (FIA). A forecast scheme based on the optimal model was developed to predict the October-November-December (OND) and March-April-May (MAM) rainfall. The predictability of GHA rainfall based on ENSO was quantified based on composite analysis, correlations and contingency tables. A test for field-significance considering the properties of finiteness and interdependence of the spatial grid was applied to avoid correlations by chance. The study identified FIA as the optimal model selection criterion. However, complex model selection criteria (FIA followed by BIC) performed better compared to simple approach (R2 and AIC). Notably, operational seasonal rainfall predictions over the GHA makes of simple model selection procedures e.g. R2. Rainfall is modestly predictable based on ENSO during OND and MAM seasons. El Nino typically leads to wetter conditions during OND and drier conditions during MAM. The correlations of ENSO indices with rainfall are statistically significant for OND and MAM seasons. Analysis based on contingency tables shows higher predictability of OND rainfall with the use of ENSO indices derived from the Pacific and Indian Oceans sea surfaces showing significant improvement during OND season. The predictability based on ENSO for OND rainfall is robust on a decadal scale compared to MAM. An ENSO-based scheme based on an optimal model selection criterion can thus provide skillful rainfall predictions over GHA. This study concludes that the
Czaczkes, Tomer J; Brandstetter, Birgit; di Stefano, Isabella; Heinze, Jürgen
Expending effort is generally considered to be undesirable. However, both humans and vertebrates will work for a reward they could also get for free. Moreover, cues associated with high-effort rewards are preferred to low-effort associated cues. Many explanations for these counterintuitive findings have been suggested, including cognitive dissonance (self-justification) or a greater contrast in state (e.g., energy or frustration level) before and after an effort-linked reward. Here, we test whether effort expenditure also increases perceived value in ants, using both classical cue-association methods and pheromone deposition, which correlates with perceived value. In 2 separate experimental setups, we show that pheromone deposition is higher toward the reward that requires more effort: 47% more pheromone deposition was performed for rewards reached via a vertical runway (high effort) compared with ones reached via a horizontal runway (low effort), and deposition rates were 28% higher on rough (high effort) versus smooth (low effort) runways. Using traditional cue-association methods, 63% of ants trained on different surface roughness, and 70% of ants trained on different runway elevations, preferred the high-effort related cues on a Y maze. Finally, pheromone deposition to feeders requiring memorization of one path bifurcation was up to 29% higher than to an identical feeder requiring no learning. Our results suggest that effort affects value perception in ants. This effect may stem from a cognitive process, which monitors the change in a generalized hedonic state before and after reward. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Klontzas, Michail E., E-mail: firstname.lastname@example.org; Karantanas, Apostolos H., E-mail: email@example.com
Objective: Greater trochanter pain syndrome (GTPS) is a diverse clinical entity caused by a variety of underlying conditions. We sought to explore the impact of (1) hip morphology, namely the center-edge angle (CEa) and femoral neck-shaft (NSa) angle, (2) hip abductor tendon degeneration, (3) the dimensions of peritrochanteric edema and (4) bursitis, on the presence of GTPS, using MR imaging. Materials and methods: The presence of pain was prospectively assessed blindly by the senior author. CEa and NSa were blindly measured in 174 hip MR examinations, after completion of the clinical evaluation by another evaluator. The existence and dimensions of T2 hyperintensity of the peritrochanteric soft tissues, the existence and dimensions of bursae, as well as degeneration and tearing of gluteus tendons were also recorded. Results: Out of 174 examinations, 91 displayed peritrochanteric edema (group A) and 34 bursitis, all with peritrochanteric edema (group B). A number of 78 patients from both A and B groups, showed gluteus medius tendon degeneration and one tendon tear. CEa of groups A and B were 6° higher than those of normals (group C, P = 0.0038). The mean age of normals was 16.6 years less than in group A and 19.8 years less than in group B (P < 0.0001). Bursitis was associated with pain with a negative predictive value of 97% (P = 0.0003). Conclusion: Acetabular morphology is associated with GTPS and the absence of bursitis was proved to be clinically relevant. Peritrochanteric edema alone was not associated with local pain.
Klontzas, Michail E.; Karantanas, Apostolos H.
Objective: Greater trochanter pain syndrome (GTPS) is a diverse clinical entity caused by a variety of underlying conditions. We sought to explore the impact of (1) hip morphology, namely the center-edge angle (CEa) and femoral neck-shaft (NSa) angle, (2) hip abductor tendon degeneration, (3) the dimensions of peritrochanteric edema and (4) bursitis, on the presence of GTPS, using MR imaging. Materials and methods: The presence of pain was prospectively assessed blindly by the senior author. CEa and NSa were blindly measured in 174 hip MR examinations, after completion of the clinical evaluation by another evaluator. The existence and dimensions of T2 hyperintensity of the peritrochanteric soft tissues, the existence and dimensions of bursae, as well as degeneration and tearing of gluteus tendons were also recorded. Results: Out of 174 examinations, 91 displayed peritrochanteric edema (group A) and 34 bursitis, all with peritrochanteric edema (group B). A number of 78 patients from both A and B groups, showed gluteus medius tendon degeneration and one tendon tear. CEa of groups A and B were 6° higher than those of normals (group C, P = 0.0038). The mean age of normals was 16.6 years less than in group A and 19.8 years less than in group B (P < 0.0001). Bursitis was associated with pain with a negative predictive value of 97% (P = 0.0003). Conclusion: Acetabular morphology is associated with GTPS and the absence of bursitis was proved to be clinically relevant. Peritrochanteric edema alone was not associated with local pain
This study characterizes an extremely large gas resource located in low permeability, overpressured sandstone reservoirs located below 8,000 feet drill depth in the Greater Green River basin, Wyoming. Total in place resource is estimated at 1,968 Tcf. Via application of geologic, engineering and economic criteria, the portion of this resource potentially recoverable as reserves is estimated. Those volumes estimated include probable, possible and potential categories and total 33 Tcf as a mean estimate of recoverable gas for all plays considered in the basin. Five plays (formations) were included in this study and each was separately analyzed in terms of its overpressured, tight gas resource, established productive characteristics and future reserves potential based on a constant $2/Mcf wellhead gas price scenario. A scheme has been developed to break the overall resource estimate down into components that can be considered as differing technical and economic challenges that must be overcome in order to exploit such resources: in other words, to convert those resources to economically recoverable reserves. Total recoverable reserves estimates of 33 Tcf do not include the existing production from overpressured tight reservoirs in the basin. These have estimated ultimate recovery of approximately 1.6 Tcf, or a per well average recovery of 2.3 Bcf. Due to the fact that considerable pay thicknesses can be present, wells can be economic despite limited drainage areas. It is typical for significant bypassed gas to be present at inter-well locations because drainage areas are commonly less than regulatory well spacing requirements.
Malaria elimination rather than control is increasingly globally endorsed, requiring new approaches wherein success is not measured by timely treatment of presenting cases but eradicating all presence of infection. This shift has gained urgency as resistance to artemisinin-combination therapies spreads in the Greater Mekong Sub-region (GMS) posing a threat to global health security. In the GMS, endemic malaria persists in forested border areas and elimination will require calibrated approaches to remove remaining pockets of residual infection. A new public health strategy called 'positive deviance' is being used to improve health promotion and community outreach in some of these zones. However, outbreaks sparked by alternative understandings of appropriate behaviour expose the unpredictable nature of 'border malaria' and difficulties eradication faces. Using a recent spike in infections allegedly linked to luxury timber trade in Thai borderlands, this article suggests that opportunities for market engagement can cause people to see 'deviance' as a means to material advancement in ways that increase disease vulnerability. A malaria outbreak in Ubon Ratchathani was investigated during two-week field-visit in November 2014 as part of longer project researching border malaria in Thai provinces. Qualitative data were collected in four villages in Ubon's three most-affected districts. Discussions with villagers focused primarily on changing livelihoods, experience with malaria, and rosewood cutting. Informants included ten men and two women who had recently overnighted in the nearby forest. Data from health officials and villagers are used to frame Ubon's rise in malaria transmission within moral and behavioural responses to expanding commodity supply-chains. The article argues that elimination strategies in the GMS must contend with volatile outbreaks among border populations wherein 'infectiousness' and 'resistance' are not simply pathogen characteristics but also
Fearon, Michelle L.; Coates, Peter S.
Nest parasitism occurs when a female bird lays eggs in the nest of another and the host incubates the eggs and may provide some form of parental care for the offspring (Lyon and Eadie 1991). Precocial birds (e.g., Galliformes and Anseriformes) are typically facultative nest parasites of both their own and other species (Lyon and Eadie 1991). This behavior increases a female’s reproductive success when she parasitizes other nests while simultaneously raising her own offspring. Both interspecific and conspecific nest parasitism have been well documented in several families of the order Galliformes, particularly the Phasianidae (Lyon and Eadie 1991, Geffen and Yom-Tov 2001, Krakauer and Kimball 2009). The Chukar (Alectoris chukar) has been widely introduced as a game bird to western North America from Eurasia and is now well established within the Great Basin from northeastern California east to Utah and north to Idaho and Oregon (Christensen 1996). Over much of this range the Chukar occurs with other phasianids, including the native Greater Sage-Grouse (Centrocercus urophasianus), within sagebrush (Artemisia spp.) steppe (Christensen 1996, Schroeder et al. 1999, Connelly et al. 2000). Chukar typically exploit a broader range of habitats than do sage-grouse, but both species use the same species of sagebrush and other shrubs for nesting cover (Christensen 1996, Schroeder et al. 1999). Chukar are known to parasitize nests of other individuals of their own species (Geffen and Yom-Tov 2001), but we are unaware of reported evidence that Chukar may parasitize nests of sage-grouse. Here we describe a case of a Chukar parasitizing a sage-grouse nest in the sagebrush steppe of western Nevada.
physics, and to whom he always remained close - his sister Maja. .... moved to Munich at the beginning of 1882, when Albert was barely two years old. ... This was demonstrated during a further change in the sphere of activity of .... As is well known, in Germany one uses the polite form "Sie" for adults and for people who.
Apr 1, 2004 ... journal Current Science, Vol 61, 1991, pp.594-600. It is an ... could be explained as mere imperfections in the fossil record. .... would almost seem that exposure to the rigours of the climate had quickened the pace ... would be interesting to know whether this telescoping effect is the outward manifesta-.
making computer programs 'human like' by building in learning and ... discussed the problems of control and communication in the living organism and the machine. ... To be effective in warding off disastrous consequences, our understanding.
not only in linguistics hut also in allied fields, splitting social scientists into t\\VO groups, Chomskyan and others. ... views on language, IlO\\\\"knoVv'Il as 'Standard Theory', generated a ... For the human mind, learning is a kind of reminiscence.
future seemed secure, and there was such complete harmony of character between ... was at once so taken with the idea that he was able to persuade Hermann Einstein to .... A liberal spirit, undogmatic in matters of religion, brought by both.
Of what lasting benefit has been man's use of science and of the new instruments which his research .... future moves about the laboratory or the field, every time he looks at something worthy of ... Yet the speed of action, the intricacy of .... physician, puzzled by a patient's reactions, strikes the trail established in studying an.
du Gay, Paul; Vikkelsø, Signe
The notion of ‘change’ has become pervasive in contemporary organizational discourse. On the one hand, change is represented as an organizational imperative that increasingly appears to trump all other concerns. On the other hand, change is addressed as an abstract, generic entity that can be the...
Newton that there was a transition to the understanding and explanation of natural .... All of this again is accessible to human understanding, and new laws of nature couched in ..... able limits to communication with other individuals.
The modem picture of the basic constituents and their interactions is described by the so called ... According to him, however great the ... Finally, it is good to remember the words of Bhabha that only science and technology can solve the.
Lepp, Margret; Zorn, CeCelia R.; Duffy, Patricia R.; Dickson, Rana J.
A nursing course connected U.S. and Swedish sites via interactive videoconferencing and used reflective methods (journaling, drama, photo language) and off-air group discussion. Evaluation by five Swedish and seven U.S. students suggested how reflection moved students toward greater authenticity and professionalism in nursing practice. (Contains…
Wells, Rachael E.; Iyengar, Sheena S.
Psychological research has repeatedly demonstrated two seemingly irreconcilable human tendencies. People are motivated towards internal consistency, or acting in accordance with stable, self-generated preferences. Simultaneously though, people demonstrate considerable variation in the content of their preferences, often induced by subtle external…
Hayes, Carolyn; Jackson, Debra; Davidson, Patricia M; Daly, John; Power, Tamara
The aim of this study was to describe the effect that immersive simulation experiences and guided reflection can have on the undergraduate nurses' understanding of how stressful environments impact their emotions, performance and ability to implement safe administration of medications. Patient safety can be jeopardised if nurses are unsure of how to appropriately manage and respond to interruptions. Medication administration errors are a major patient safety issue and often occur as a consequence of ineffective interruption management. The skills associated with medication administration are most often taught to, and performed by, undergraduate nurses in a controlled environment. However, the clinical environment in which nurses are expected to administer medications is often highly stressed and nurses are frequently interrupted. This study used role-play simulation and written reflections to facilitate deeper levels of student self-awareness. A qualitative approach was taken to explore students' understanding of the effects of interruptions on their ability to undertake safe medication administration. Convenience sampling of second-year undergraduate nursing students enrolled in a medical-surgical subject was used in this study. Data were obtained from 451:528 (85.42%) of those students and analysed using thematic analysis. Students reported increasing consciousness and the importance of reflection for evaluating performance and gaining self-awareness. They described self-awareness, effective communication, compassion and empathy as significant factors in facilitating self-efficacy and improved patient care outcomes. Following a role-play simulation experience, student nurses reported new knowledge and skill acquisition related to patient safety, and new awareness of the need for empathetic and compassionate care during medication administration. Practicing medication administration in realistic settings adds to current strategies that aim to reduce medication
Full Text Available Ectopic decidua is defined as extrauterine deposits of decidual stromal cells. It occurs in 85-100% of pregnancies. Focal sites can be present in various locations, yet a peritoneal location is rare. A 24- year- old woman underwent a cesarean section in 39th week of her first pregnancy, during which adhesions of the omentum to the fundus, entire left side of the uterus, and a part of the right front abdominal wall were found. An operative specimen was taken for a pathohistological analysis under the assumption of being fibrous adhesive tissue. The analysis revealed ectopic decidual tissue composed of large, polygonal cells with eosinophilic cytoplasm, and large nuclei with conspicuous nucleoli infiltrated with mature fatty cells and lymphocytes. Strong staining for vimentin was observed in the decidual cell cytoplasm and for a progesterone- receptor in the cell nuclei, medium staining was detected for S-100, and negative staining for CK 5/ 6, HMB-45, desmin, smooth muscle actin, estrogen and androgen- receptors. We present this case in order to educate clinicians and pathologists about the phenomenon of ectopic deciduosis. Although it can exist as asymptomatic condition, we point out the importance of considering this condition since it can result in serious pathology, like intraperitoneal hemorrhage and labour obstruction, if remains unrecognized. Another pitfall is possible confusion of this entity with other conditions. A resemblance to adhesions of the omentum and malignant neoplastic lesions, like squamous cell and metastatic carcinoma, metastatic melanoma, malignant decidual mesothelioma, metastatic mucin -producing adenocarcinoma, can be deceiving. These obstacles may present a pitfall to clinicians and pathologists, with a negative impact on patient treatment and outcome.
Lyons-Ruth, K.; Pechtel, P.; Yoon, S.A.; Anderson, C.M.; Teicher, M.H.
Early life stress in rodents is associated with increased amygdala volume in adulthood. In humans, the amygdala develops rapidly during the first two years of life. Thus, disturbed care during this period may be particularly important to amygdala development. In the context of a 30-year longitudinal study of impoverished, highly stressed families, we assessed whether disorganization of the attachment relationship in infancy was related to amygdala volume in adulthood. Amygdala volumes were assessed among 18 low-income young adults (8M/10F, 29.33±0.49 years) first observed in infancy (8.5±5.6 months) and followed longitudinally to age 29. In infancy (18.58±1.02 mos), both disorganized infant attachment behavior and disrupted maternal communication were assessed in the standard Strange Situation Procedure (SSP). Increased left amygdala volume in adulthood was associated with both maternal and infant components of disorganized attachment interactions at 18 months of age (overall r = .679, p attachment disturbance in adolescence, were not significantly related to left amygdala volume. Left amygdala volume was further associated with dissociation and limbic irritability in adulthood. Finally, left amygdala volume mediated the prediction from attachment disturbance in infancy to limbic irritability in adulthood. Results point to the likely importance of quality of early care for amygdala development in human children as well as in rodents. The long-term prediction found here suggests that the first two years of life may be an early sensitive period for amygdala development during which clinical intervention could have particularly important consequences for later child outcomes. PMID:27060720
Koriat, Asher; Adiv, Shiri; Schwarz, Norbert
Research on group influence has yielded a prototypical majority effect (PME): Majority views are endorsed faster and with greater confidence than minority views, with the difference increasing with majority size. The PME was attributed to conformity pressure enhancing confidence in consensual views and causing inhibition in venturing deviant opinions. Our results, however, indicate that PME for binary choices can arise from the process underlying confidence and latency independent of social influence. PME was demonstrated for tasks and conditions that are stripped of social relevance; it was observed in within-individual analyses in contrasting the individual's more frequent and less frequent responses to the same item, and was found for the predictions of others' responses. A self-consistency model, which assumes that choice and confidence are based on the sampling of representations from a commonly shared pool of representations, yielded a PME for confidence and latency. Behavioral implications of the results are discussed. © 2015 by the Society for Personality and Social Psychology, Inc.
Ala, Fereydoun; Allain, Jean-Pierre; Bates, Imelda; Boukef, Kamel; Boulton, Frank; Brandful, James; Dax, Elizabeth M.; El Ekiaby, Magdy; Farrugia, Albert; Gorlin, Jed; Hassall, Oliver; Lee, Helen; Loua, André; Maitland, Kathryn; Mbanya, Dora; Mukhtar, Zainab; Murphy, William; Opare-Sem, Ohene; Owusu-Ofori, Shirley; Reesink, Henk; Roberts, David; Torres, Oscar; Totoe, Grace; Ullum, Henrik; Wendel, Silvano
Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking
Full Text Available Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking.
Ala, Fereydoun; Allain, Jean-Pierre; Bates, Imelda; Boukef, Kamel; Boulton, Frank; Brandful, James; Dax, Elizabeth M.; El Ekiaby, Magdy; Farrugia, Albert; Gorlin, Jed; Hassall, Oliver; Lee, Helen; Loua, André; Maitland, Kathryn; Mbanya, Dora
Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking.
Conner, Tamlin S; Brookie, Kate L; Richardson, Aimee C; Polak, Maria A
that FV consumption may be related to a broader range of well-being states that signal human flourishing in early adulthood. Statement of contribution What is already known on this subject? There is growing evidence that a diet rich in fruits and vegetables (FV) is related to greater happiness, life satisfaction, and positive affect. These associations are not entirely explained by demographic or health variables including socio-economic status, exercise, smoking, and body mass index (BMI). Recent experimental and daily diary research suggests that FV consumption may be a causal factor in promoting states of positive well-being. Research has examined the links between FV consumption and hedonic well-being - whether people feel good (vs. bad) and satisfied-but has not addressed links between FV consumption and eudaemonic well-being- whether people feel engaged and experience their lives as meaningful and purposeful. What does this study add? It provides the first evidence that eating FV is related to greater eudaemonic well-being in a naturalistic setting. Eating FV was also related to greater self-reported curiosity and creativity. FV consumption may underlie a broad range of experiences that signal flourishing. Future randomised controlled trials of FV should include measures of eudaemonic well-being as outcome variables. © 2014 The British Psychological Society.
Scicluna Helen A
Full Text Available Abstract Background The University of New South Wales (UNSW Faculty of Medicine replaced its old content-based curriculum with an innovative new 6-year undergraduate entry outcomes-based integrated program in 2004. This paper is an initial evaluation of the perceived and assessed clinical capabilities of recent graduates of the new outcomes-based integrated medical program compared to benchmarks from traditional content-based or process-based programs. Method Self-perceived capability in a range of clinical tasks and assessment of medical education as preparation for hospital practice were evaluated in recent graduates after 3 months working as junior doctors. Responses of the 2009 graduates of the UNSW’s new outcomes-based integrated medical education program were compared to those of the 2007 graduates of UNSW’s previous content-based program, to published data from other Australian medical schools, and to hospital-based supervisor evaluations of their clinical competence. Results Three months into internship, graduates from UNSW’s new outcomes-based integrated program rated themselves to have good clinical and procedural skills, with ratings that indicated significantly greater capability than graduates of the previous UNSW content-based program. New program graduates rated themselves significantly more prepared for hospital practice in the confidence (reflective practice, prevention (social aspects of health, interpersonal skills (communication, and collaboration (teamwork subscales than old program students, and significantly better or equivalent to published benchmarks of graduates from other Australian medical schools. Clinical supervisors rated new program graduates highly capable for teamwork, reflective practice and communication. Conclusions Medical students from an outcomes-based integrated program graduate with excellent self-rated and supervisor-evaluated capabilities in a range of clinically-relevant outcomes. The program
Petzold, D.E.; Goward, S.N.
Lichens constitute a major portion of the ground cover of high latitude environments, but little has been reported concerning their in situ solar spectral reflectance properties. Knowledge of these properties is important for the interpretation of remotely sensed observations from high latitude regions, as well as in studies of high latitude ecology and energy balance climatology. The spectral reflectance of common boreal vascular plants is similar to that of vascular plants of the mid latitudes. The dominant lichens, in contrast, display variable reflectance patterns in visible wavelengths. The relative reflectance peak at 0.55 μm, common to green vegetation, is absent or indistinct in spectra of pervasive boreal forest and tundra lichens, despite the presence of chlorophyll in the inner algal cells. Lichens of the dominant genus, Cladina, display strong absorption of ultraviolet energy and short-wavelength blue light relative to their absorption in other visible wavelengths. Since the Cladinae dominate both the surface vegetation in open woodlands of the boreal forest and the low arctic tundra, their unusual spectral reflectance patterns will enable accurate monitoring of the boreal forest-tundra ecotone and detection of its vigor and movement in the future. (author)
Ives, R. Lawrence; Mizuhara, Yosuke M
A load for traveling microwave energy has an absorptive volume defined by cylindrical body enclosed by a first end cap and a second end cap. The first end cap has an aperture for the passage of an input waveguide with a rotating part that is coupled to a reflective mirror. The inner surfaces of the absorptive volume consist of a resistive material or are coated with a coating which absorbs a fraction of incident RF energy, and the remainder of the RF energy reflects. The angle of the reflector and end caps is selected such that reflected RF energy dissipates an increasing percentage of the remaining RF energy at each reflection, and the reflected RF energy which returns to the rotating mirror is directed to the back surface of the rotating reflector, and is not coupled to the input waveguide. Additionally, the reflector may have a surface which generates a more uniform power distribution function axially and laterally, to increase the power handling capability of the RF load. The input waveguide may be corrugated for HE11 mode input energy.
Petzold, Donald E.; Goward, Samuel N.
Lichens constitute a major portion of the ground cover of high latitude environments, but little has been reported concerning their in situ solar spectral reflectance properties. Knowledge of these properties is important for the interpretation of remotely sensed observations from high latitude regions, as well as in studies of high latitude ecology and energy balance climatology. The spectral reflectance of common boreal vascular plants is similar to that of vascular plants of the midlatitudes. The dominant lichens, in contrast, display variable reflectance patterns in visible wavelengths. The relative reflectance peak at 0.55 microns, common to green vegetation, is absent or indistinct in spectra of pervasive boreal forest and tundra lichens, despite the presence of chlorophyll in the inner algal cells. Lichens of the dominant genus, Cladina, display strong absorption of ultraviolet energy and short-wavelength blue light relative to their absorption in other visible wavelengths. Since the Cladinae dominate both the surface vegetation in open woodlands of the boreal forest and the low arctic tundra, their unusual spectral reflectance patterns will enable accurate monitoring of the boreal forest-tundra ecotone and detection of its vigor and movement in the future.
Full Text Available Erin Akar, Bodo E KnudsenDepartment of Urology, Ohio State University Wexner Medical Center, Columbus, OH, USAAbstract: The purpose of this review, based on the current evidence in the literature, is whether ureteroscopy (URS is a comparable primary treatment option to the current gold standard of percutaneous nephrolithotomy (PCNL for the treatment of large kidney stones 2 cm or greater. The lack of prospective randomized trials directly comparing URS and PCNL makes comparison challenging. The numerous studies are not standardized in terms of their definition of stone-free or how stone size is reported. In order to standardize comparison of results, we used a stone-free definition of <4 mm after one procedure per imaging of the author’s choice, since how each patient was imaged postoperatively was not reported. The results from the literature show that moderately large stones from 2 to 3 cm treated ureteroscopically have similar outcomes to PCNL. Stone-free rates with URS decrease when stone size is above 3 cm. Our interpretation of the literature suggests that a current limitation of URS is that multiple procedures for URS would be required to achieve comparable stone-free rates to PCNL, particularly for stones greater than 4 cm.Keywords: ureteroscopy, percutaneous nephrolithotomy, lithotripsy, urinary calculi
Padoin, Alexandre Vontobel; Galvão Neto, Manoel; Moretto, Myriam; Barancelli, Fabiano; Schroer, Caroline Eckerdt; Mottin, Cláudio Corá
Dumping syndrome is one of ten most common complications in morbidly obese patients operated. Recent studies in relation to type 2 diabetes mellitus (DM2) in patients submitted to gastric bypass led us to examine the different outcomes in this group of patients. Our objective was to determine the difference in the prevalence of dumping syndrome in patients with DM2 submitted to gastric bypass. In this retrospective study, 49 diabetic and 54 non-diabetic morbidly obese patients were submitted to gastric bypass and followed up at 3, 6, and 12 months after surgery. The occurrence of dumping was determined by the patient's medical chart, where it was considered positive if recorded in at least one of three evaluations. The 103 patients evaluated had a mean BMI of 49.5 +/- 9.3 kg/m(2) and mean age of 38 +/- 9.7 years, with 75.7% being women. The prevalence of dumping syndrome in this population was 24.3%. The prevalence of dumping was greater in patients with DM2 (44.9%) when compared to the control group (5.6%; p DM2 as the only variable associated with dumping syndrome. Dumping syndrome is a common postoperative complication in gastric bypass. Patients with DM2 show a greater postoperative prevalence of dumping.
Smoski, Moria J; Rittenberg, Alison; Dichter, Gabriel S
Anhedonia, the loss of interest or pleasure in normally rewarding activities, is a hallmark feature of unipolar Major Depressive Disorder (MDD). A growing body of literature has identified frontostriatal dysfunction during reward anticipation and outcomes in MDD. However, no study to date has directly compared responses to different types of rewards such as pleasant images and monetary rewards in MDD. To investigate the neural responses to monetary and pleasant image rewards in MDD, a modified Monetary Incentive Delay task was used during functional magnetic resonance imaging to assess neural responses during anticipation and receipt of monetary and pleasant image rewards. Participants included nine adults with MDD and 13 affectively healthy controls. The MDD group showed lower activation than controls when anticipating monetary rewards in right orbitofrontal cortex and subcallosal cortex, and when anticipating pleasant image rewards in paracingulate and supplementary motor cortex. The MDD group had relatively greater activation in right putamen when anticipating monetary versus pleasant image rewards, relative to the control group. Results suggest reduced reward network activation in MDD when anticipating rewards, as well as relatively greater hypoactivation to pleasant image than monetary rewards. 2011 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Background: Self-mastery is an important psychological resource to cope with stressful situations. However, we have limited understanding of self-mastery among minority aging populations. Objective: This study aims to examine the presence and levels of self-mastery among U.S. Chinese older adults. Methods: Data were drawn from the PINE study, a population-based survey of U.S. Chinese older adults in the Greater Chicago area. Guided by a community-based participatory research approach, a total of 3,159 Chinese older adults aged 60 and above were surveyed. A Chinese version of the Self-Mastery Scale was used to assess self-mastery. Results: Out of the 7-item Chinese Self-Mastery Scale, approximately 42.8% to 87.5% of Chinese older adults experienced some degree of self-mastery in their lives. Older adults with no formal education and the oldest-old aged 85 and over had the lowest level of self-mastery in our study. A higher mastery level was associated with being married, having fewer children, better self-reported health status, better quality of life, and positive health changes. Conclusion: Although self-mastery is commonly experienced among the Chinese aging population in the Greater Chicago area, specific subgroups are still vulnerable. Future longitudinal studies are needed to improve the understanding of risk factors and outcomes associated with self-mastery among Chinese older adults.
Edmunds, David; Aldridge, Cameron L.; O'Donnell, Michael; Monroe, Adrian
The scale at which analyses are performed can have an effect on model results and often one scale does not accurately describe the ecological phenomena of interest (e.g., population trends) for wide-ranging species: yet, most ecological studies are performed at a single, arbitrary scale. To best determine local and regional trends for greater sage-grouse (Centrocercus urophasianus) in Wyoming, USA, we modeled density-independent and -dependent population growth across multiple spatial scales relevant to management and conservation (Core Areas [habitat encompassing approximately 83% of the sage-grouse population on ∼24% of surface area in Wyoming], local Working Groups [7 regional areas for which groups of local experts are tasked with implementing Wyoming's statewide sage-grouse conservation plan at the local level], Core Area status (Core Area vs. Non-Core Area) by Working Groups, and Core Areas by Working Groups). Our goal was to determine the influence of fine-scale population trends (Core Areas) on larger-scale populations (Working Group Areas). We modeled the natural log of change in population size ( peak M lek counts) by time to calculate the finite rate of population growth (λ) for each population of interest from 1993 to 2015. We found that in general when Core Area status (Core Area vs. Non-Core Area) was investigated by Working Group Area, the 2 populations trended similarly and agreed with the overall trend of the Working Group Area. However, at the finer scale where Core Areas were analyzed separately, Core Areas within the same Working Group Area often trended differently and a few large Core Areas could influence the overall Working Group Area trend and mask trends occurring in smaller Core Areas. Relatively close fine-scale populations of sage-grouse can trend differently, indicating that large-scale trends may not accurately depict what is occurring across the landscape (e.g., local effects of gas and oil fields may be masked by increasing
Steyn, Frederik J; Ioannides, Zara A; van Eijk, Ruben P A; Heggie, Susan; Thorpe, Kathryn A; Ceslis, Amelia; Heshmat, Saman; Henders, Anjali K; Wray, Naomi R; van den Berg, Leonard H; Henderson, Robert D; McCombe, Pamela A; Ngo, Shyuan T
To determine the prevalence of hypermetabolism, relative to body composition, in amyotrophic lateral sclerosis (ALS) and its relationship with clinical features of disease and survival. Fifty-eight patients with clinically definite or probable ALS as defined by El Escorial criteria, and 58 age and sex-matched control participants underwent assessment of energy expenditure. Our primary outcome was the prevalence of hypermetabolism in cases and controls. Longitudinal changes in clinical parameters between hypermetabolic and normometabolic patients with ALS were determined for up to 12 months following metabolic assessment. Survival was monitored over a 30-month period following metabolic assessment. Hypermetabolism was more prevalent in patients with ALS than controls (41% vs 12%, adjusted OR=5.4; pALS. Mean lower motor neuron score (SD) was greater in hypermetabolic patients when compared with normometabolic patients (4 (0.3) vs 3 (0.7); p=0.04). In the 12 months following metabolic assessment, there was a greater change in Revised ALS Functional Rating Scale score in hypermetabolic patients when compared with normometabolic patients (-0.68 points/month vs -0.39 points/month; p=0.01). Hypermetabolism was inversely associated with survival. Overall, hypermetabolism increased the risk of death during follow-up to 220% (HR 3.2, 95% CI 1.1 to 9.4, p=0.03). Hypermetabolic patients with ALS have a greater level of lower motor neuron involvement, faster rate of functional decline and shorter survival. The metabolic index could be important for informing prognosis in ALS. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Krueger, Donata; Jeong, Cheol-Ho; Brunskog, Jonas
For reasonably accurate but practical auralizations, some simplifications and approximations are needed. The main issue in the present investigation is that the reflection density of a room impulse response, in theory, increases so fast as a quadratic function of the elapsed time, even assuming...
Cathro, Virginia; O'Kane, Paula; Gilbertson, Deb
Purpose: The purpose of this paper is to suggest ways in which business educators can interact successfully with reflective learning journals (RLJs). Specifically, the research was interested in how students used RLJs and how educators assessed these RLJs. Design/methodology/approach: In total, 31 RLJs, submitted as part of an international…
This article explores the role of drawing as a tool for reflection. It reports on a PhD research project that aims to identify and analyse the value that co-design processes can bring to participants and their communities. The research is associated with Leapfrog, a three-year project funded by the UK Arts and Humanities Research Council (AHRC).…
with both youth and the parental generation with ethnic minority background in Denmark. These reflections include implications and challenges related to researcher’s national, ethnic background and educational, professional position in encounter with diverse ‘researched persons’ such as youth......This article reflects on the methodological and epistemological aspects of the ethical issues involved in encounters between researcher and research participants with ethnic minority background in contexts with diversity. Specific challenges involved in longitudinal research (10 - 15 years......) are also considered. The issues related to the social relevance of the research deriving from psycho political validity implying consideration of power dynamics in the personal, relational and collective domains are included. The primary basis for these reflections is a follow-up study concerning young...
Schumann Scheel, Linda; Peters, Micah D J; Meinertz Møbjerg, Anna Christine
REVIEW QUESTION/OBJECTIVE: This scoping review will seek to find answers for the following questions which will focus on the use of reflection in the education of nurses in clinical settings:The review will also extract and map data regarding: i) what outcomes have been found in relation to the use...... (e.g. first or second year undergraduate nursing students etc.); and v) barriers/challenges to the use of reflection approaches/tools. Additional details may also be extracted and mapped during the process of the scoping review and this will be explained in the final scoping review report....
A description is given of a reflecting variable opening insulating panel assembly, comprising a static panel assembly of reflecting insulation sheets forming a cavity along one side of the panel and a movable panel opening out by sliding from the cavity of the static panel, and a locking device for holding the movable panel in a position extending from the cavity of the static panel. This can apply to a nuclear reactor of which the base might require maintenance and periodical checking and for which it is desirable to have available certain processes for the partial dismantling of the insulation [fr
Lee, Jeong Soo; Ku, Ja Seung; Seong, Baek Seok; Lee, Chang Hee; Hong, Kwang Pyo; Choi, Byung Hoon
This report contains reduction and fitting process of neutron reflectivity data by REFLRED and REFLFIT in NIST. Because the detail of data reduction like BKG, footprint and data normalization was described, it will be useful to the user who has no experience in this field. Also, reflectivity and BKG of d-PS thin film were measured by HANARO neutron reflectometer. From these, the structure of d-PS thin film was analyzed with REFLRED and REFLFIT. Because the structure of thin film such as thickness, roughness and SLD was attained in the work, the possibility of data analysis with REFLRED and REFLFIT was certified
Živković Predrag Ž.
Full Text Available in many historical and comparative overviews of the works, in which there is an analytical discussion of the dominant pedagogical theories in the twentieth century, John Dewey (Dewey, 1933 is referred to as the founder and creator of the concept of reflection (reflective thought and knowledge in practice. Reflection as a concept is understood as the forms and the form of problem solving, as well as continuously thinking about the causes of problems in situations in situ, including active and systematically and consistently changing connecting ideas with solutions to the problems and situations that preceded them (Hatton & Smith, 1995. Reflective thinking is the most general level to tackle practical problems, allowing the ''recommended'' doubts and confusion before proposing possible solutions to the problem. Dewey wrote about a reflective action which refers to the use of solutions to the problem and to thinking through the course of the action. in later works of the authors who have dealt with this problem, an unambiguous link can be observed between the so-called ''professional'' action and the reflection on action which, in this cyclical relationship, leads to visible changes (Zeichner & Gore, 1984. Already at first glance, this implies a connection with experiential learning and adult position of observation and reflection in various models of experiential learning, which will be discussed later. it would be useful to compare this method with a cyclic action of routine as an expression of impulse, tradition and authority. Reflective action, as opposed to the routine, is a consistently and carefully thought-out action (practice reflection, which is an ''awakened'' knowledge and belief, and that is an expression of openness, accountability and commitment. We are ready for reflection, says Schon, when the ''knowledge-in-action'' - a kind of knowledge that professionals notice when it is acted spontaneously - occurs suddenly and unintentionally
Jensen, Karsten Klint; Forsberg, Ellen-Marie; Gamborg, Christian; Millar, Kate; Sandøe, Peter
Several studies have indicated that scientists are likely to have an outlook on both facts and values that are different to that of lay people in important ways. This is one significant reason it is currently believed that in order for scientists to exercise a reliable ethical reflection about their research it is necessary for them to engage in dialogue with other stakeholders. This paper reports on an exercise to encourage a group of scientists to reflect on ethical issues without the presence of external stakeholders. It reports on the use of a reflection process with scientists working in the area of animal disease genomics (mainly drawn from the EADGENE EC Network of Excellence). This reflection process was facilitated by using an ethical engagement framework, a modified version of the Ethical Matrix. As judged by two criteria, a qualitative assessment of the outcomes and the participants' own assessment of the process, this independent reflective exercise was deemed to be successful. The discussions demonstrated a high level of complexity and depth, with participants demonstrating a clear perception of uncertainties and the context in which their research operates. Reflection on stakeholder views and values appeared to be embedded within the discussions. The finding from this exercise seems to indicate that even without the involvement of the wider stakeholder community, valuable reflection and worthwhile discourse can be generated from ethical reflection processes involving only scienitific project partners. Hence, the previous assumption that direct stakeholder engagement is necessary for ethical reflection does not appear to hold true in all cases; however, other reasons for involving a broad group of stakeholders relating to governance and social accountability of science remain.
Winkel, Abigail Ford; Yingling, Sandra; Jones, Aubrie-Ann; Nicholson, Joey
Graduate medical education programs employ reflection to advance a range of outcomes for physicians in training. However, the most effective applications of this tool have not been fully explored. A systematic review of the literature examined interventions reporting the use of reflection in graduate medical education. The authors searched Medline/PubMed, Embase, Cochrane CENTRAL, and ERIC for studies of reflection as a teaching tool to develop medical trainees' capacities. Key words and subject headings included reflection , narrative , residents/GME , and education / teaching / learning . No language or date limits were applied. The search yielded 1308 citations between inception for each database and June 15, 2015. A total of 16 studies, encompassing 477 residents and fellows, met eligibility criteria. Study quality was assessed using the Critical Appraisal Skills Programme Qualitative Checklist. The authors conducted a thematic analysis of the 16 articles. Outcomes studied encompassed the impact of reflection on empathy, comfort with learning in complex situations, and engagement in the learning process. Reflection increased learning of complex subjects and deepened professional values. It appears to be an effective tool for improving attitudes and comfort when exploring difficult material. Limitations include that most studies had small samples, used volunteers, and did not measure behavioral outcomes. Critical reflection is a tool that can amplify learning in residents and fellows. Added research is needed to understand how reflection can influence growth in professional capacities and patient-level outcomes in ways that can be measured.
Roessger, Kevin M.
In work-related instrumental learning contexts, the role of reflective activities is unclear. Kolb's experiential learning theory and Mezirow's transformative learning theory predict skill adaptation as an outcome. This prediction was tested by manipulating reflective activities and assessing participants' response and error rates during novel…
Mauroux, Laetitia; Könings, Karen D.; Zufferey, Jessica Dehler; Gurtner, Jean-Luc
While learning journals (LJs) have been shown to support self-regulated learning strategies, reflection and learning outcomes in academic contexts, few studies have investigated their relevance in vocational education. A mobile and online learning journal (MOLJ) was developed to support reflection on workplace experiences. However, acceptance of…
Neumann, Yoram; Neumann, Edith; Lewis, Shelia
Based on recent studies of self-reflective learning and its effects on various learning outcomes, this study examined the concept of self-reflective learning in the context of the Robust Learning Model (RLM), which is a learning model designed for improving the educational effectiveness of online degree programs. Two models were introduced to…
, worthwhileness, happiness and anxiety. The correlation analysis outcomes can be divided into three levels such as Greater London as a whole, and Inner and Outer London. In Greater London, total area of green spaces has a strong relation with crime rates, and a less strong relation with number of jobs. Both socioeconomic indicators showed a negative trend along with the increase of open spaces. In terms of wellbeing indicators, the positive trend of life satisfaction, worthwhileness and happiness, and the negative trend of anxiety can be found in accordance with the increase of green coverage. In Inner London, job density and crime rates show a negative trend in accordance with the increase of total open space areas. And as contagion of open spaces is higher, the indicators of number of jobs, jobs density, and crime rates also showed an increase tendency. As for worthwhileness and happiness, it also showed a substantial correlation with contagion of open spaces. In Outer London, the correlation between job density and crime rates, and open space cannot be found, but the wellbeing indicators such as life satisfaction and worthwhileness show an increase trend along with larger green coverage.
fixative used, types of specimen containers and appropriate labeling of containers. ... specimen and with wide mouth and tight fitting lid) and adequacy of container .... surgeons in this respect is a reflection of greater availability of prepared ...
Verbrugge, J.K.; Verbrugge, J.K.
The dissertation is a reflection of the writer on his career as an industrial designer of Demand-Driven Design for a period of approximately 25 years. This period is exposed with a discussion of five designs. The projects are introduced by developments in the surrounding design landscape, such as
Adams, Helen R.
Each profession has its own code of ethics. The Merriam-Webster Online Dictionary (2008) defines professional ethics as "the principles of conduct governing an individual or a group." The Code of Ethics of the American Library Association (ALA Council 2008) has served librarians for seventy years and reflects the ideals toward which all librarians…
Schmidt, Christopher D.
Current literature on ethics and moral development focuses on discussion concerning the impact of intuition on moral decision-making. Through the use of student journal reflections over the course of one semester, this study utilized a grounded theory approach in order to explore and understand participant levels of awareness and understanding of…
Enloe, Walter; Cogan, John
The bombing of Hiroshima changed forever the concept of conflict and warfare in the human family. Two Americans, one having grown up in Hiroshima and the other having spent one year in the city as a Fullbright research scholar, reflect on the Hiroshima experience. (RM)
Boden, Carrie J.; Cook, Deborah; Lasker-Scott, Tennille; Moore, Sylvia; Shelton, Debbie
It has long been posited in the field of adult education and elsewhere that reflection is an integral part of one's teaching practice and as well as a beneficial learning tool for students. It was with this orientation to practice that Dr. Carrie J. Boden started her first year of teaching in the Adult Education Masters Degree Program at the…
Eerden, F.J.M. van der; Lutgendorf, D.; Roo, F. de
Within the EU FP7 QUIESST project, QUIeting the Environment for a Sustainable Surface Transport, a test method is being developed for the reflectivity of noise barriers. The method needs to account for a complex shape of barriers and the use of various types of absorbing materials. The performance
Laimre, Marko, 1968-
Pealkirja "Vegetables, Coctails & Reflections" kandis Tallinna Kunstihoones 8.04.-28.05.2006 avatud Elin Kardi, Marko Mäetamme, Marco Laimre ja Andres Tali ühisnäitusel "Vägivald ja propaganda" Marco Laimre installatsioon. Marco Laimre esinemine raadiosaates "kunst.er" Klassikaraadios 16.04.2006
KLAUS, DAVID J.; AND OTHERS
THIS VOLUME 2 OF A TWO-VOLUME SET PROVIDES AUTOINSTRUCTION IN PHYSICS. THE UNITS COVERED IN THIS VOLUME ARE (1) REFLECTION OF LIGHT, (2) PHOTOMETRY, (3) POLARIZATION, (4) REFRACTION OF LIGHT, (5) SNELL'S LAW, (6) LENSES, FOCUS, AND FOCAL POINTS, (7) IMAGE FORMATION, AND (8) ABERRATIONS, THE EYE, AND MAGNIFICATION. THE INTRODUCTION AND UNITS ON…
Ribeiro, Jair Lúcio Prados
A disco ball is a spherical object covered with small plane mirrors. When light reflects on these mirrors, it is scattered in many directions, producing a novel effect. The mirror globe is usually set to rotate, creating a profusion of moving spots (Fig. 1). In this article, we present a geometrical description of the movement of these spots and…
Nelissen, J.M.C.; Tomic, W.
The present article explores the theoretical underpinnings upon which Russian psychologists base their analysis of reflection. The intention is to arrive at a clearer understanding of their research aims and research methods, and to explore the relevance of their research to educational practice.
In accordance with the present invention there is provided a radiographic camera comprising: a scintillator; a plurality of photodectors positioned to face said scintillator; a plurality of masked regions formed upon a face of said scintillator opposite said photdetectors and positioned coaxially with respective ones of said photodetectors for decreasing the amount of internal reflection of optical photons generated within said scintillator. (auth)
Tuite, P.; Tuite, K.; O'Kelley, M.; Ely, P.
This study provides a quantitative framework for bounding unpackaged greater-than-Class C low-level radioactive waste types as a function of concentration averaging. The study defines the three concentration averaging scenarios that lead to base, high, and low volumetric projections; identifies those waste types that could be greater-than-Class C under the high volume, or worst case, concentration averaging scenario; and quantifies the impact of these scenarios on identified waste types relative to the base case scenario. The base volume scenario was assumed to reflect current requirements at the disposal sites as well as the regulatory views. The high volume scenario was assumed to reflect the most conservative criteria as incorporated in some compact host state requirements. The low volume scenario was assumed to reflect the 10 CFR Part 61 criteria as applicable to both shallow land burial facilities and to practices that could be employed to reduce the generation of Class C waste types
Jiang, Xing-Hui; Liu, Han-Ping; Guo, Zhou-Yi; Meng, Yao-Yong; Zeng, Chang-Chun; Liu, Song-Hao
Acupoint was reaction of viscera and its optical parameter was an important characteristic of tissue. In the present work, in order to discuss specificity of acupuncture on the response of qi and blood in human body, we compared the diffuse reflectance of Taichong (LV3), Taibai (SP3), and Chongyang (ST42) before, during and after menstruation. All the acupoints had the same shape of the spectrum and troughs were all at 423.16, 544.06 and 577.47 nm. The values of reflectance during menstruation were greater than before and after menstruation, especially for SP3 and ST42 (P menstruation. Diffuse reflectance may be possibly used in the quantitative analysis of qi and blood.
Blazquez, Carlos H.; Nigg, H. N.; Hedley, Lou E.; Ramos, L. E.; Sorrell, R. W.; Simpson, S. E.
Spectral reflectance measurements from 400 to 800 nm were taken from immature and mature leaves of grapefruit ('McCarty' and 'Rio Red'), 'Minneola' tangelo, 'Satsuma' mandarin, 'Dancy' tangerine, 'Nagami' oval kumquat, and 'Valencia' sweet orange, at the Florida Citrus Arboretum, Division of Plant Industry, Winter Haven, Florida. Immature and mature leaves of 'Minneola' tangelo had greater percent reflectance in the 400 to 800 nm range than the other varieties and leaf ages measured. The slope of the citrus spectral curves in the 800 nm range was not as sharp as conventional spectrometers, but had a much higher reflectance value than those obtained with a DK-2 spectrometer. Statistical analyses of absolute spectral data yielded significant differences between mature and immature leaves and between varieties. First derivative data analyses did not yield significant differences between varieties.
vanderSluis, CK; Kingma, J; Eisma, WH; tenDuis, HJ
Objective: To assess the short-term and long-term outcomes of pediatric polytrauma patients and to analyze the extent to which short-term outcomes can predict long-term outcomes. Materials and Methods: Ail pediatric polytrauma patients (Injury Severity Score of greater than or equal to 16, less than
Kaliannan, Maniam; Chandran, Suseela Devi
There has been greater attention in recent times on the outcomes of the education system so that the return on investments in education could be evaluated. It is measured based on tangible performance indicators and intangible students' outcome known as outcome-based education (OBE). Universiti Teknologi MARA Malaysia has implemented an OBE system…
Full Text Available Learning theories and their interpretations in management research recognize the role of reflection as a central element in the learning process. There also exists a broad consensus that organizational learning (OL happens at three intertwined levels of the individual, the group and the organization. This tri-level analysis has been most influentially presented by Crossan, Lane and White (1999, as a premise for their 4I framework of OL. Though the 4I framework builds strongly on existing literature on OL, it does not address the role of reflection as a factor operating between the inputs and outcomes in 4I sub-processes. Though a large body of research exists regarding the notion of reflection and its importance in terms of OL, this has not been discussed in the specific context of the 4I framework. This article contributes to the development of the 4I model by discussing how reflective practice—on three levels and within 4I sub-processes—fuels the OL process. The argumentation is based on an extensive literature review in three dimensions of learning, illustrated with an empirical inquiry into three business organizations and their reflective practice. In addition, the aim is to increase the understanding of reflection as not only an individual or group process, but as an organized practice, enabled by the tools of management control.
LaLonde, Mary M; Dreier, Mona; Aaronson, Gayle; O'Brien, John
The self begins as a social self and is dependent on the other and the self-other relationship. Furthermore, shortly after birth, the intersubjective self is nurtured and sustained by the reciprocal interactions with the significant other. Recent research suggests that the significant other's reciprocity depends on his or her capacity for mentalization, and this reflective functioning capacity influences not only the child's developing sense of I, other, and we, but also his or her developing attachment pattern. Several studies have demonstrated that parental reflective functioning can be improved with intervention, and enhancing parental reflective functioning can lead to a more secure attachment pattern and better outcomes for the child and parent. Therefore, intervention with toddlers and their families requires us to consider this dynamic two-person psychology. In this paper, we describe an academic parent-child nursery program aimed at enhancing parental reflective functioning. A clinical example from the collaborative treatment of a mother and her two-year-old will demonstrate how reflective functioning can be enhanced in the parent-child dyad and lead to a more secure parent-child relationship. We will also discuss the value of reflective functioning to the interdisciplinary team and how we dealt with countertransference issues that arose during the treatment.
Plant, Jennifer; Li, Su-Ting T; Blankenburg, Rebecca; Bogetz, Alyssa L; Long, Michele; Butani, Lavjay
To explore when and in what form pediatric faculty and residents practice reflection. From February to June 2015, the authors conducted focus groups of pediatric faculty and residents at the University of California, Davis; Stanford University; and the University of California, San Francisco, until thematic saturation occurred. Transcripts were analyzed based on Mezirow's and Schon's models of reflection, using the constant comparative method associated with grounded theory. Two investigators independently coded transcripts and reconciled codes to develop themes. All investigators reviewed the codes and developed a final list of themes through consensus. Through iterative discussions, investigators developed a conceptual model of reflection in the clinical setting. Seventeen faculty and 20 residents from three institutions participated in six focus groups. Five themes emerged: triggers of reflection, intrinsic factors, extrinsic factors, timing, and outcome of reflection. Various triggers led to reflection; whether a specific trigger led to reflection depended on intrinsic and extrinsic factors. When reflection occurred, it happened in action or on action. Under optimal conditions, this reflection was goal and action directed and became critical reflection. In other instances, this process resulted in unproductive rumination or acted as an emotional release or supportive therapy. Participants reflected in clinical settings, but did not always explicitly identify it as reflection or reflect in growth-promoting ways. Strategies to enhance critical reflection include developing knowledge and skills in reflection, providing performance data to inform reflection, creating time and space for safe reflection, and providing mentorship to guide the process.
Monroe, Adrian P; Aldridge, Cameron L; Assal, Timothy J; Veblen, Kari E; Pyke, David A; Casazza, Michael L
Human land use, such as livestock grazing, can have profound yet varied effects on wildlife interacting within common ecosystems, yet our understanding of land-use effects is often generalized from short-term, local studies that may not correspond with trends at broader scales. Here we used public land records to characterize livestock grazing across Wyoming, USA, and we used Greater Sage-grouse (Centrocercus urophasianus) as a model organism to evaluate responses to livestock management. With annual counts of male Sage-grouse from 743 leks (breeding display sites) during 2004-2014, we modeled population trends in response to grazing level (represented by a relative grazing index) and timing across a gradient in vegetation productivity as measured by the Normalized Vegetation Difference Index (NDVI). We found grazing can have both positive and negative effects on Sage-grouse populations depending on the timing and level of grazing. Sage-grouse populations responded positively to higher grazing levels after peak vegetation productivity, but populations declined when similar grazing levels occurred earlier, likely reflecting the sensitivity of cool-season grasses to grazing during peak growth periods. We also found support for the hypothesis that effects of grazing management vary with local vegetation productivity. These results illustrate the importance of broad-scale analyses by revealing patterns in Sage-grouse population trends that may not be inferred from studies at finer scales, and could inform sustainable grazing management in these ecosystems. © 2017 by the Ecological Society of America.
Full Text Available In the spirit of critical reflection, we examine how the field of global health might surmount current challenges and prioritize its ethical mandate, namely to achieve, for all people, equity in health. We use the parlance of mastering deadly sins and striving for greater virtues in an effort to review what is needed to transform global health action. Global health falls prey to four main temptations: coveting silo gains, lusting for technological solutions, leaving broad promises largely unfulfilled, and boasting of narrow successes. This necessitates a change of heart: to keep faith with the promise it made, global health requires a realignment of core values and a sharper focus on the primacy of relationships with the communities it serves. Based on the literature to date, we highlight six steps to re-orienting global health action. Articulating a coherent global health agenda will come from principled action, enacted through courage and prudence in decision-making to foster people-centered systems of care over the entire lifespan.
Ledger, W; Wiebinga, C; Anderson, P; Irwin, D; Holman, A; Lloyd, A
Cost and outcome estimates based on clinical trial data may not reflect usual clinical practice, yet they are often used to inform service provision and budget decisions. To expand understanding of assisted reproduction treatment in clinical practice, an economic evaluation of IVF/intracytoplasmic sperm injection (ICSI) data from a single assisted conception unit (ACU) in England was performed. A total of 1418 IVF/ICSI cycles undertaken there between October 2001 and January 2006 in 1001 women were analysed. The overall live birth rate was 22% (95% CI: 19.7-24.2), with the 30- to 34-year age group achieving the highest rate (28%). The average recombinant FSH (rFSH) dose/cycle prescribed was 1855 IU. Average cost of rFSH/cycle was 646 pound(SD: 219 pound), and average total cost/cycle was 2932 pound (SD: 422 pound). Economic data based on clinical trials informing current UK guidance assumes higher doses of rFSH dose/cycle (1750-2625 IU), higher average cost of drugs/cycle (1179 pound), and higher average total cost/cycle (3266 pound). While the outcomes in this study matched UK averages, total cost/cycle was lower than those cited in UK guidelines. Utilizing the protocols and (lower) rFSH dosages reported in this study may enable other ACU to provide a greater number of IVF/ICSI cycles to patients within given budgets.
As part of SCK-CEN's social sciences and humanities programme, a reflection group on 'Expert Culture' was established. The objectives of the reflection group are: (1) to clarify the role of SCK-CEN experts; (2) to clarify the new role of expertise in the evolving context of risk society; (3) to confront external views and internal SCK-CEN experiences on expert culture; (4) to improve trust building of experts and credibility of SCK-CEN as a nuclear actor in society; (5) to develop a draft for a deontological code; (6) to integrate the approach in training on assertivity and communication; (7) to create an output for a topical day on the subject of expert culture. The programme, achievements and perspectives of the refection group are summarised
AIKEN, DANIEL J.
Analytical expressions used to optimize AR coatings for single junction solar cells are extended for use in monolithic, series interconnected multi-junction solar cell AR coating design. The result is an analytical expression which relates the solar cell performance (through J(sub sc)) directly to the AR coating design through the device reflectance. It is also illustrated how AR coating design be used to provide an additional degree of freedom for current matching multi-junction devices
Even though data acquisition and data processing procedures have become more and more complex in recent decades, the end products of a reflection seismic survey have remained simple and illustrative. A seismic section resembles a geological cross-section and can be interpreted without in-depth knowledge provided that the basic principles behind the method are understood. This article attempts to convey some insight into the methodology without claiming to be scientifically exact or complete. (author)
Newton, Ryan J.; McLellan, Sandra L.; Dila, Deborah K.; Vineis, Joseph H.; Morrison, Hilary G.; Eren, A. Murat
ABSTRACT Molecular characterizations of the gut microbiome from individual human stool samples have identified community patterns that correlate with age, disease, diet, and other human characteristics, but resources for marker gene studies that consider microbiome trends among human populations scale with the number of individuals sampled from each population. As an alternative strategy for sampling populations, we examined whether sewage accurately reflects the microbial community of a mixture of stool samples. We used oligotyping of high-throughput 16S rRNA gene sequence data to compare the bacterial distribution in a stool data set to a sewage influent data set from 71 U.S. cities. On average, only 15% of sewage sample sequence reads were attributed to human fecal origin, but sewage recaptured most (97%) human fecal oligotypes. The most common oligotypes in stool matched the most common and abundant in sewage. After informatically separating sequences of human fecal origin, sewage samples exhibited ~3× greater diversity than stool samples. Comparisons among municipal sewage communities revealed the ubiquitous and abundant occurrence of 27 human fecal oligotypes, representing an apparent core set of organisms in U.S. populations. The fecal community variability among U.S. populations was significantly lower than among individuals. It clustered into three primary community structures distinguished by oligotypes from either: Bacteroidaceae, Prevotellaceae, or Lachnospiraceae/Ruminococcaceae. These distribution patterns reflected human population variation and predicted whether samples represented lean or obese populations with 81 to 89% accuracy. Our findings demonstrate that sewage represents the fecal microbial community of human populations and captures population-level traits of the human microbiome. PMID:25714718
Full Text Available Several recent studies have suggested that cues that predict outcomes elicit a feedback-related-like negativity (FRN-like negativity reflecting initial appraisals of whether desired outcomes are probable. Some other studies, however, have found that the cues that predict outcomes elicited event-related potentials (ERPs that reflect the expectation to outcomes (e.g., outcome expectations. Given these mixed findings, this study aimed to examine whether the brain activity elicited by predictive cues in a gambling task reflected the initial evaluations of the outcomes, the outcome expectations, or both. We used a gambling task in which the participants were told to guess which of two doors hid a reward. At the beginning of each trial, a cue was presented to inform the participants of how many doors hid a reward. We found that these predictive cues elicited a FRN-like negativity at the frontal sites within around 200–300 ms. However, this negativity did not significantly differ between the cues that fully predicted gains and the cues that fully predicted losses. Furthermore, predictive cues elicited an expectation-related slow wave, and cues that predicted gains with a 50% probability elicited a larger expectation-related slow wave than cues that fully predicted gains or losses. Our results suggest that cues predicting outcomes reflect outcome expectations rather than initial evaluations of the forthcoming outcomes.
Sofer, Sigal; Eliraz, Abraham; Kaplan, Sara; Voet, Hillary; Fink, Gershon; Kima, Tzadok; Madar, Zecharia
This study was designed to investigate the effect of a low-calorie diet with carbohydrates eaten mostly at dinner on anthropometric, hunger/satiety, biochemical, and inflammatory parameters. Hormonal secretions were also evaluated. Seventy-eight police officers (BMI >30) were randomly assigned to experimental (carbohydrates eaten mostly at dinner) or control weight loss diets for 6 months. On day 0, 7, 90, and 180 blood samples and hunger scores were collected every 4 h from 0800 to 2000 hours. Anthropometric measurements were collected throughout the study. Greater weight loss, abdominal circumference, and body fat mass reductions were observed in the experimental diet in comparison to controls. Hunger scores were lower and greater improvements in fasting glucose, average daily insulin concentrations, and homeostasis model assessment for insulin resistance (HOMA(IR)), T-cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) levels were observed in comparison to controls. The experimental diet modified daily leptin and adiponectin concentrations compared to those observed at baseline and to a control diet. A simple dietary manipulation of carbohydrate distribution appears to have additional benefits when compared to a conventional weight loss diet in individuals suffering from obesity. It might also be beneficial for individuals suffering from insulin resistance and the metabolic syndrome. Further research is required to confirm and clarify the mechanisms by which this relatively simple diet approach enhances satiety, leads to better anthropometric outcomes, and achieves improved metabolic response, compared to a more conventional dietary approach.
Head, Barbara J; Aquilino, Mary Lober; Johnson, Marion; Reed, David; Maas, Meridean; Moorhead, Sue
To evaluate the content validity and nursing sensitivity of six community-level outcomes from the Nursing Outcomes Classification (NOC; Johnson, Maas, & Moorhead, 2000). A survey research design was used. Questionnaires were mailed to 300 public health nursing experts; 102 nurses responded. Experts evaluated between 11 and 30 indicators for each of the six outcomes for: (a) importance of the indicators for measuring the outcome, and (b) influence of nursing on the indicators. Content validity and nursing sensitivity of the outcomes were estimated with a modified Fehring technique. All outcomes were deemed important; only Community Competence had an outcome content validity score < .80. The outcome sensitivity score for Community Health: Immunity was .80; other outcome scores ranged from .62-.70. Indicator ratios for all 102 indicators met the study criterion for importance, with 87% designated as critical and 13% as supplemental. Sensitivity ratios reflected judgments that 45% of the indicators were sensitive to nursing intervention. The study provided evidence of outcome content validity and nursing sensitivity of the study outcomes; further validation research is recommended, followed by testing of the study outcomes in clinical practice. Community-level nursing-sensitive outcomes will potentially enable study of the efficacy and effectiveness of public health interventions focused on improving health of populations and communities.
Christine E. Blake
Full Text Available Background. Prior studies suggest that weight satisfaction may preclude changes in behavior that lead to healthier weight among individuals who are overweight or obese. Objective. To gain a better understanding of complex relationships between weight satisfaction, weight-related health behaviors, and health outcomes. Design. Cross-sectional analysis of data from the Aerobics Center Longitudinal Study (ACLS. Participants. Large mixed-gender cohort of primarily white, middle-to-upper socioeconomic status (SES adults with baseline examination between 1987 and 2002 (n=19,003. Main Outcome Variables. Weight satisfaction, weight-related health behaviors, chronic health conditions, and clinical health indicators. Statistical Analyses Performed. Chi-square test, t-tests, and linear and multivariate logistic regression. Results. Compared to men, women were more likely to be dieting (32% women; 18% men and had higher weight dissatisfaction. Men and women with greater weight dissatisfaction reported more dieting, yo-yo dieting, and snacking and consuming fewer meals, being less active, and having to eat either more or less than desired to maintain weight regardless of weight status. Those who were overweight or obese and dissatisfied with their weight had the poorest health. Conclusion. Greater satisfaction with one’s weight was associated with positive health behaviors and health outcomes in both men and women and across weight status groups.
Morgan, D P
This paper presents a new approximate method for analyzing reflective SAW transducers, with much of the convenience of the coupled-mode (COM) method but with better accuracy. Transduction accuracy is obtained by incorporating the accurate electrostatic solution, giving for example correct harmonics, and allowance for electrode width variation, in a simple manner. Results are shown for a single-electrode transducer, Natural SPUDT and DART SPUDT, each using theoretically derived parameters. In contrast to the COM, the RAM can give accurate results for short or withdrawal-weighted transducers and for wide analysis bandwidth.
McCarthy, Eoghan M
Early intervention for rheumatic disease has been shown to improve prognosis, but is dependent on the recognition of pertinent symptoms and signs. This study was undertaken to identify the attitudes of junior doctors toward musculoskeletal assessment. The charts of 100 randomly selected medical patients admitted via the Emergency Department were reviewed for documentation of the musculoskeletal system. In addition, junior doctors were interviewed regarding their views on musculoskeletal assessment. Only 16% of medical admission notes contained a reference to the musculoskeletal system and the recording of joint examinations was incomplete in all cases. Prior training in musculoskeletal assessment depended on the joint area involved (hand, 100%; foot, 36.2%). Most doctors felt competent in hand assessment (68.8%) but only 12.5% could examine the foot. More than one third could not confidently diagnose common rheumatic conditions, while 75% felt unable to diagnose a connective tissue disorder. The majority (88.7%) regarded the musculoskeletal assessment as difficult\\/challenging and 61.3% thought that it should not be included as part of a general medical examination. However, 80% of doctors felt that they had not received adequate teaching in musculoskeletal assessment and would welcome further training. The omission of the musculoskeletal assessment for medical patients admitted to hospital is reflected in the fact that doctors lack training in this area. Furthermore, doctors lack confidence in their ability to recognise both common and rare rheumatic diagnoses, a problem likely to impact adversely on the outcome of patients with these conditions.
Stone, Austin V; Howse, Elizabeth A; Mannava, Sandeep; Stubbs, Allston J
To evaluate the clinical symptoms and intraoperative pathology associated with hip pain in the cyclist compared with a matched hip arthroscopy surgical group. In an institutional review board-approved study, we retrospectively reviewed a prospective database of 1,200 consecutive hip arthroscopy patients from 2008 to 2015. Adult patients were identified who reported cycling as a major component of their activity. Patients were age, gender, and body mass index matched to a control, noncycling group. Pain symptoms, preoperative examinations, radiographic and operative findings were compared. Primary outcome variables included the femoral and acetabular Outerbridge chondromalacia grade. Additional outcome measurements included the involved area and the chondromalacia index (CMI; the product of the Outerbridge chondromalacia grade and surface area [mm 2 × severity]). A total of 167 noncyclists were matched to the cycling group (n = 16). Cyclists had significantly greater femoral head chondromalacia grade (2.0 [95% confidence interval (CI), 1.5-2.5] v 1.4 [95% CI, 1.3-1.6], P = .043), femoral head chondromalacia area (242 mm 2 [95% CI, 191-293 mm 2 ] v 128 mm 2 [95% CI, 113-141 mm 2 ], P chondromalacia than a matched group of noncyclists. Cycling activity positively correlated with the presence of femoral chondromalacia with clinically significant gait alterations. These data support the hypothesis that cyclists with hip pain have more chondral pathology than a similar group of other patients with hip pain. Ultimately, cyclists with hip pain should be identified as higher risk for more advanced chondral damage. Level III, case-control study, therapeutic. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Madsen, Heather B; Ahmed, Serge H
Despite the unique ability of addictive drugs to directly activate brain reward circuits, recent evidence suggests that drugs induce reinforcing and incentive effects that are comparable to, or even lower than some nondrug rewards. In particular, when rats have a choice between pressing a lever associated with intravenous cocaine or heroin delivery and another lever associated with sweet water delivery, most respond on the latter. This outcome suggests that sweet water is more reinforcing and attractive than either drug. However, this outcome may also be due to the differential ability of sweet versus drug levers to elicit Pavlovian feeding-like conditioned responses that can cause involuntary lever pressing, such as pawing and biting the lever. To test this hypothesis, rats first underwent Pavlovian conditioning to associate one lever with sweet water (0.2% saccharin) and a different lever with intravenous cocaine (0.25 mg) or heroin (0.01 mg). Choice between these two levers was then assessed under two operant choice procedures: one that permitted the expression of Pavlovian-conditioned lever press responses during choice, the other not. During conditioning, Pavlovian-conditioned lever press responses were considerably higher on the sweet lever than on either drug lever, and slightly greater on the heroin lever than on the cocaine lever. Importantly, though these differences in Pavlovian-conditioned behavior predicted subsequent preference for sweet water during choice, they were not required for its expression. Overall, this study confirms that rats prefer the sweet lever because sweet water is more reinforcing and attractive than cocaine or heroin. © 2014 Society for the Study of Addiction.
Rinker, Brian; Zoldos, Jozef; Weber, Renata V; Ko, Jason; Thayer, Wesley; Greenberg, Jeffrey; Leversedge, Fraser J; Safa, Bauback; Buncke, Gregory
Processed nerve allografts (PNAs) have been demonstrated to have improved clinical results compared with hollow conduits for reconstruction of digital nerve gaps less than 25 mm; however, the use of PNAs for longer gaps warrants further clinical investigation. Long nerve gaps have been traditionally hard to study because of low incidence. The advent of the RANGER registry, a large, institutional review board-approved, active database for PNA (Avance Nerve Graft; AxoGen, Inc, Alachua, FL) has allowed evaluation of lower incidence subsets. The RANGER database was queried for digital nerve repairs of 25 mm or greater. Demographics, injury, treatment, and functional outcomes were recorded on standardized forms. Patients younger than 18 and those lacking quantitative follow-up data were excluded. Recovery was graded according to the Medical Research Council Classification for sensory function, with meaningful recovery defined as S3 or greater level. Fifty digital nerve injuries in 28 subjects were included. There were 22 male and 6 female subjects, and the mean age was 45. Three patients gave a previous history of diabetes, and there were 6 active smokers. The most commonly reported mechanisms of injury were saw injuries (n = 13), crushing injuries (n = 9), resection of neuroma (n = 9), amputation/avulsions (n = 8), sharp lacerations (n = 7), and blast/gunshots (n = 4). The average gap length was 35 ± 8 mm (range, 25-50 mm). Recovery to the S3 or greater level was reported in 86% of repairs. Static 2-point discrimination (s2PD) and Semmes-Weinstein monofilament (SWF) were the most common completed assessments. Mean s2PD in 24 repairs reporting 2PD data was 9 ± 4 mm. For the 38 repairs with SWF data, protective sensation was reported in 33 repairs, deep pressure in 2, and no recovery in 3. These data compared favorably with historical data for nerve autograft repairs, with reported levels of meaningful recovery of 60% to 88%. There were no reported adverse effects
Allen, Harris; Woock, Christopher; Barrington, Linda; Bunn, William
To expand a study of the impact of overtime on employee health, safety, and productivity outcomes, previously reported in this journal, with tests comparing older versus younger workers on these relationships. Secondary analyses of a longitudinal panel (n = 2746) representing workers at US sites for a heavy manufacturer during 2001 to 2002. Structural equation techniques were used to assess two hypotheses in the context of multiple group models positing the prediction of a broad set of employee outcomes using a three-step causal sequence. One set of models compared overtime impact for three age groups (increases were largely confined to hourly employees working extended overtime (averaging 60+ hours per week) and occurred on only four of the nine study outcomes. With respect to moderate overtime (48.01 to 59.99 hours) and to variables reflecting the possible impact of past overtime (eg, prior disability episodes), increases in age among hourly employees did not lead to stronger associations between overtime and adverse outcomes on most tests and in fact in many cases were linked to decrements in these associations (hypothesis #2). Salaried employees recorded no greater linkages between overtime and adverse outcomes with advancing age across all tests involving hypothesized overtime effects or "possibly a function of overtime" effects. The results support the proposition that, when employees work overtime, adverse outcomes--and indirect costs--do not increase with advancing age in any kind of wholesale fashion. Where rates of adverse outcomes do increase, they are confined to certain subgroups of employees doing certain types of work and occur on certain dimensions at certain levels of longer work hours. It is argued that carefully calibrated approaches vis-à-vis older workers are needed to maximize employer capacity to address the unique challenges posed by this increasingly important portion of the workforce.
Denniston, Charlotte; Molloy, Elizabeth; Nestel, Debra; Woodward-Kron, Robyn; Keating, Jennifer L
The aim of this study was to identify and analyse communication skills learning outcomes via a systematic review and present results in a synthesised list. Summarised results inform educators and researchers in communication skills teaching and learning across health professions. Systematic review and qualitative synthesis. A systematic search of five databases (MEDLINE, PsycINFO, ERIC, CINAHL plus and Scopus), from first records until August 2016, identified published learning outcomes for communication skills in health professions education. Extracted data were analysed through an iterative process of qualitative synthesis. This process was guided by principles of person centredness and an a priori decision guide. 168 papers met the eligibility criteria; 1669 individual learning outcomes were extracted and refined using qualitative synthesis. A final refined set of 205 learning outcomes were constructed and are presented in 4 domains that include: (1) knowledge (eg, describe the importance of communication in healthcare), (2) content skills (eg, explore a healthcare seeker's motivation for seeking healthcare),( 3) process skills (eg, respond promptly to a communication partner's questions) and (4) perceptual skills (eg, reflect on own ways of expressing emotion). This study provides a list of 205 communication skills learning outcomes that provide a foundation for further research and educational design in communication education across the health professions. Areas for future investigation include greater patient involvement in communication skills education design and further identification of learning outcomes that target knowledge and perceptual skills. This work may also prompt educators to be cognisant of the quality and scope of the learning outcomes they design and their application as goals for learning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Bassi, Francesco; Carr, Alan B.; Chang, Ting-Ling; Estafanous, Emad; Garrett, Neal R.; Happonen, Risto-Pekka; Koka, Sreenivas; Laine, Juhani; Osswald, Martin; Reintsema, Harry; Rieger, Jana; Roumanas, Eleni; Salinas, Thomas J.; Stanford, Clark M.; Wolfaardt, Johan
The published literature describing clinical evidence used in treatment decision-making for the management of tooth loss continues to be characterized by a lack of consistent outcome measures reflecting not only clinical performance but also a range of patient concerns. Recognizing this problem, an
Holm, Claus; Steenholdt, Niels
The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education, which reflects that some students taking accounting classes also are provided with on-the-job training in accountin...
Haegens, Saskia; Vergara, José; Rossi-Pool, Román; Lemus, Luis; Romo, Ranulfo
Previous work on perceptual decision making in the sensorimotor system has shown population dynamics in the beta band, corresponding to the encoding of stimulus properties and the final decision outcome. Here, we asked how oscillatory dynamics in the medial premotor cortex (MPC) contribute to supramodal perceptual decision making. We recorded local field potentials (LFPs) and spikes in two monkeys trained to perform a tactile-acoustic frequency discrimination task, including both unimodal and crossmodal conditions. We studied the role of oscillatory activity as a function of stimulus properties (frequency and sensory modality), as well as decision outcome. We found that beta-band power correlated with relevant stimulus properties: there was a significant modulation by stimulus frequency during the working-memory (WM) retention interval, as well as modulation by stimulus modality-the latter was observed only in the case of a purely unimodal task, where modality information was relevant to prepare for the upcoming second stimulus. Furthermore, we found a significant modulation of beta power during the comparison and decision period, which was predictive of decision outcome. Finally, beta-band spike-field coherence (SFC) matched these LFP observations. In conclusion, we demonstrate that beta power in MPC is reflective of stimulus features in a supramodal, context-dependent manner, and additionally reflects the decision outcome. We propose that these beta modulations are a signature of the recruitment of functional neuronal ensembles, which encode task-relevant information.
McCloskey, Patrick J.
Julius Bennett was once a disinterested student destined to become a dropout. Then he enrolled in Amistad Academy, an academically focused charter middle school intent on narrowing the achievement gap between urban and suburban kids located in New Haven, Connecticut. Now Julius is making plans for college. In this article the author details the…
Wulff, M; Burke, T; Newton, P
With more than a quarter of its population born overseas, Melbourne, Australia, is rapidly changing from an all-white British outpost to a multicultural, multilingual community. Since the "white" Australian policy was abandoned after World War II, 3 million immigrants from 100 different countries have moved to Australia. Most of the immigrants come from New Zealand, Rhodesia, South Africa, Britain, Ireland, Greece, Turkey, Yugoslavia, Poland, and Indochina. Melbourne is Australia's 2nd largest city and houses 1 out of 5 Australians. Its 1984 population was 2,888,400. Melbourne's housing pattern consists of subdivisions; 75% of the population live in detached houses. Between 1954 and 1961 Melbourne grew at an annual rate of 3.5%; its growth rate between 1961 and 1971 still averaged 2.5%. In the 1970s the growth rate slowed to 1.4%. Metropolitan Melbourne has no central government but is divided into 56 councils and 8 regions. Both Australia's and Melbourne's fertility rates are high compared to the rest of the developed world, partly because of their younger age structure. 41% of Melbourne's population was under age 24 in 1981. Single-person households are growing faster than any other type. 71% of the housing is owner-occupied; in 1981 the median sized dwelling had 5.2 rooms. Public housing only accounts for 2.6% of all dwellings. Fewer students graduate from high school in Australia than in other developed countries, and fewer graduates pursue higher education. Melbourne's suburban sprawl promotes private car travel. In 1980 Melbourne contained more than 28,000 retail establishments and 4200 restaurants and hotels. Industry accounts for 30% of employment, and services account for another 30%. Its largest industries are motor vehicles, clothing, and footware. Although unemployment reached 10% after the 1973 energy crisis, by 1985 it was down to 6%.
Chase, Tannah; Wetterneck, Chad T; Bartsch, Robert A; Leonard, Rachel C; Riemann, Bradley C
Despite the heterogeneous nature of obsessive-compulsive disorder (OCD), many self-report assessments do not adequately capture the clinical picture presenting within each symptom dimension, particularly unacceptable thoughts (UTs). In addition, obsessions and ordering/arranging compulsions are often underrepresented in samples of treatment outcome studies for OCD. Such methodological discrepancies may obscure research findings comparing treatment outcomes across OCD symptom dimensions. This study aimed to improve upon previous research by investigating treatment outcomes across OCD symptom dimensions using the Dimensional Obsessive-Compulsive Scale, which offers a more comprehensive assessment of UTs. The study included a primarily residential sample of 134 OCD patients. Results indicated that there were no significant differences in treatment outcomes across symptom dimensions. However, the severity of UTs remained significantly greater than other symptom dimensions at both admission and discharge. Thus, it is possible that UTs may exhibit uniquely impairing features, compared with other symptom dimensions. It is also possible that these findings may reflect the characteristics of the residential OCD samples. These speculations as well as implications for OCD treatment and future research are discussed.
Ullman, Sarah E
This article provides a retrospective account of my experience embarking on research about women's resistance to rape, including reflections on personal and professional experiences related to studying this topic. I discuss factors inspiring my interest, including pioneering feminist rape researchers, my experience as a woman living with the reality and fear of rape, and influential mentors who facilitated my career development as a scholar in graduate school and beyond. I weave this narrative together with my thoughts about how the study of resistance relates to other important issues in the field of sexual assault including alcohol, recovery, and prevention.
Ian Campbell's paper, originally delivered at a conference on the development of 'The reflective practitioner' while he was Unit General Manager of Sunderland Royal Infirmary, describes the liaison between general and nurse managers in the hospital. Management must give a hospital organisation direction and must set the parameters of corporate and individual performance, but it must also be responsive to the feedback received from practising clinicians. The key concept is quality of service, and in this managers and practitioners can work together towards a common goal.
Upon receiving US NRC's approval in 2010, the first RPS/ESPS digital upgrade using TELEPERM® XS technology was successfully installed in Spring of 2011 at the first Unit of a three-unit station, followed by the 2nd Unit installation in spring of 2012. Both Units' systems have been operating flawlessly since installation. After about two years of operation, a reflection on digital upgrades and lessons learned, from a vendor perspective, provides valuable insight for the commercial nuclear power industry.
Dedyulina Marina Anatolevna
Full Text Available The problem of digital divide itself is interesting for philosophical reflection as it lies at the crossroads of interests of social and political philosophy, philosophy of technology and epistemology, and these are just some of them. Due to the constant development of information technologies and the introduction of new technologies the digital divide is a dynamic problem. The main aim of this work is to analyse the conceptual and descriptive aspects of the problem of the digital divide, to get a more complete picture of the phenomenon. The digital divide is a complex problem that has social, political, cultural and ethical aspects.
We shall reflect on the results of Design Methodology research and their impact on design practice. In the past 50 years the number of researchers in the field has expanded enormously – as has the number of publications. During the same period design practice and its products have changed...... and produced are also now far more complex and distributed, putting designers under ever increasing pressure. We shall address the question: Are the results of Design Methodology research appropriate and are they delivering the expected results in design practice? In our attempt to answer this question we...
Full Text Available The standard model involves particle symmetry and the mechanism of its breaking. Modern cosmology is based on inflationary models with baryosynthesis and dark matter/energy, which involves physics beyond the standard model. Studies of the physical basis of modern cosmology combine direct searches for new physics at accelerators with its indirect non-accelerator probes, in which cosmological consequences of particle models play an important role. The cosmological reflection of particle symmetry and the mechanisms of its breaking are the subject of the present review.
Van Lier, Jens; Moulds, Michelle L; Raes, Filip
Generalizing from a single failure or success to future performances and their self-concept could have an important impact on sport participants. This study examined the impact of the way sport participants think about success on positive generalization. Sport participants (N = 222) completed an online experimental study in which they were induced to think about meanings, causes and implications (i.e., abstract-"why"-thinking) or about more perceptual concrete aspects of their performance (i.e., concrete-"how"-thinking). We hypothesized that abstract-"why"-thinking would lead to greater positive generalization and that this effect would be moderated by self-esteem. Our results supported our hypothesis that abstract thinking increased positive generalization, and this effect was more clearly visible in sport participants with higher self-esteem. These results suggest that retrospective thinking about the "why" of a good performance may benefit athletes in the long run because they generalize the outcome to future performances and their self-concept which may boost their motivation and consequently their performance.
Marshall, David F; Walker, Sara J; Ryan, Kelly A; Kamali, Masoud; Saunders, Erika F H; Weldon, Anne L; Adams, Kenneth M; McInnis, Melvin G; Langenecker, Scott A
Measures of cognitive dysfunction in Bipolar Disorder (BD) have identified state and trait dependent metrics. An influence of substance abuse (SUD) on BD has been suggested. This study investigates potential differential, additive, or interactive cognitive dysfunction in bipolar patients with or without a history of SUD. Two hundred fifty-six individuals with BD, 98 without SUD and 158 with SUD, and 97 Healthy Controls (HC) completed diagnostic interviews, neuropsychological testing, and symptom severity scales. The BD groups exhibited poorer performance than the HC group on most cognitive factors. The BD with SUD exhibited significantly poorer performance than BD without SUD in visual memory and conceptual reasoning/set-shifting. In addition, a significant interaction effect between substance use and depressive symptoms was found for auditory memory and emotion processing. BD patients with a history of SUD demonstrated worse visual memory and conceptual reasoning skills above and beyond the dysfunction observed in these domains among individuals with BD without SUD, suggesting greater impact on integrative, gestalt-driven processing domains. Future research might address longitudinal outcome as a function of BD, SUD, and combined BD/SUD to evaluate neural systems involved in risk for, and effects of, these illnesses. Published by Elsevier Ireland Ltd.
Nehme, Ziad; Boyle, Malcolm J
Suboptimal bag ventilation in cardiopulmonary resuscitation (CPR) has demonstrated detrimental physiological outcomes for cardiac arrest patients. In light of recent guideline changes for resuscitation, there is a need to identify the efficacy of bag ventilation by prehospital care providers. The objective of this study was to evaluate bag ventilation in relation to operator ability to achieve guideline consistent ventilation rate, tidal volume and minute volume when using two different capacity self-inflating bags in an undergraduate paramedic cohort. An experimental study using a mechanical lung model and a simulated adult cardiac arrest to assess the ventilation ability of third year Monash University undergraduate paramedic students. Participants were instructed to ventilate using 1600 ml and 1000 ml bags for a length of two minutes at the correct rate and tidal volume for a patient undergoing CPR with an advanced airway. Ventilation rate and tidal volume were recorded using an analogue scale with mean values calculated. Ethics approval was granted. Suboptimal ventilation with the use of conventional 1600 ml bag was common, with 77% and 97% of participants unable to achieve guideline consistent ventilation rates and tidal volumes respectively. Reduced levels of suboptimal ventilation arouse from the use of the smaller bag with a 27% reduction in suboptimal tidal volumes (p = 0.015) and 23% reduction in suboptimal minute volumes (p = 0.045). Smaller self-inflating bags reduce the incidence of suboptimal tidal volumes and minute volumes and produce greater guideline consistent results for cardiac arrest patients.
Jens eVan Lier
Full Text Available Generalizing from a single failure or success to future performances and their self-concept could have an important impact on sport participants. This study examined the impact of the way sport participants think about success on positive generalization. Sport participants (N=222 completed an online experimental study in which they were induced to think about meanings, causes and implications (i.e., abstract-‘why’-thinking or about more perceptual concrete aspects of their performance (i.e., concrete-‘how’-thinking. We hypothesized that abstract-‘why’-thinking would lead to greater positive generalization and that this effect would be moderated by self-esteem. Our results supported our hypothesis that abstract thinking increased positive generalization, and this effect was more clearly visible in sport participants with higher self-esteem. These results suggest that retrospective thinking about the ‘why’ of a good performance may benefit athletes in the long run because they generalize the outcome to future performances and their self-concept which may boost their motivation and consequently their performance.
Walton, Jo Ann; Lindsay, Natalie; Hales, Caz; Rook, Helen
This study was born out of our reflections as educators responsible for helping new graduate nurses transition into their first year of professional practice through a formal education programme. Finding ourselves wondering about many of the questions the students raised with us, we set about looking more closely at what could be gleaned from the students' experience, captured in their written work over the course of a year. To identify the challenges and learning experiences revealed in reflective assignments written by new graduate nurses undertaking a postgraduate course as part of their transition to registered nurse practice. Data consisted of the written work of two cohorts of students who had completed a postgraduate university course as part of their transition to new graduate practice in New Zealand. Fifty four reflective essays completed by twenty seven participating students were collected and their contents analysed thematically. Five key themes were identified. The students' reflections noted individual attributes - personal and professional strengths and weaknesses; professional behaviour - actions such as engaging help and support, advocating for patients' needs and safety and putting their own feelings aside; situational challenges such as communication difficulties, both systemic and interpersonal, and the pressure of competing demands. Students also identified rewards - results they experienced such as achieving the nursing outcomes they desired, and commented on reflection as a useful tool. The findings shed light on the experiences of new graduates, and how they fare through this critical phase of career development. Challenges relating to the emotional labour of nursing work are particularly evident. In addition the reflective essay is shown to be a powerful tool for assisting both new graduate nurses and their lecturers to reflect on the learning opportunities inherent in current clinical practice environments. Copyright © 2017 Elsevier Ltd
MacLennan, Donald A.; Turner, Brian P.; Kipling, Kent
A discharge lamp includes an envelope, a fill which emits light when excited disposed in the envelope, a source of excitation power coupled to the fill to excite the fill and cause the fill to emit light, and a reflector disposed around the envelope and defining an opening, the reflector being configured to reflect some of the light emitted by the fill back into the fill while allowing some light to exit through the opening. The reflector may be made from a material having a similar thermal index of expansion as compared to the envelope and which is closely spaced to the envelope. The envelope material may be quartz and the reflector material may be either silica or alumina. The reflector may be formed as a jacket having a rigid structure which does not adhere to the envelope. The lamp may further include an optical clement spaced from the envelope and configured to reflect an unwanted component of light which exited the envelope back into the envelope through the opening in the reflector. Light which can be beneficially recaptured includes selected wavelength regions, a selected polarization, and selected angular components.
Symes, W W
The seismic reflection method seeks to extract maps of the Earth's sedimentary crust from transient near-surface recording of echoes, stimulated by explosions or other controlled sound sources positioned near the surface. Reasonably accurate models of seismic energy propagation take the form of hyperbolic systems of partial differential equations, in which the coefficients represent the spatial distribution of various mechanical characteristics of rock (density, stiffness, etc). Thus the fundamental problem of reflection seismology is an inverse problem in partial differential equations: to find the coefficients (or at least some of their properties) of a linear hyperbolic system, given the values of a family of solutions in some part of their domains. The exploration geophysics community has developed various methods for estimating the Earth's structure from seismic data and is also well aware of the inverse point of view. This article reviews mathematical developments in this subject over the last 25 years, to show how the mathematics has both illuminated innovations of practitioners and led to new directions in practice. Two themes naturally emerge: the importance of single scattering dominance and compensation for spectral incompleteness by spatial redundancy. (topical review)
McGuinty, Everett; Nelson, John; Carlson, Alain; Crowther, Eric; Bednar, Dina; Foroughe, Mirisse
The zeitgeist for short-term psychotherapy efficacy has fundamentally shifted away from evidence-based practices to include evidence-informed practices, resulting in an equally important paradigm shift in outcome measurement designed to reflect change in this short-term modality. The present article delineates a short-term psychotherapy structure which defines four fundamental stages that all brief therapies may have in common, and are represented through Cognitive Behavioral Therapy, Solution-Focused Brief Therapy, Narrative Therapy, and Emotion-Focused Therapy. These four theoretical approaches were analyzed via a selected literature review through comparing and contrasting specific and common tasks as they relate to the process of psychotherapy and change. Once commonalities were identified within session, they were categorized or grouped into themes or general stages of change within the parameters of a four to six session model of short-term therapy. Commonalities in therapeutic stages of change may more accurately and uniformly measure outcome in short-term work, unlike the symptom-specific psychometric instruments of longer-term psychotherapy. A systematic framework for evaluating the client and clinician adherence to 20 specific tasks for these four short-term therapies is presented through the newly proposed, Brief Task Acquisition Scale (BTAS). It is further proposed that the client-clinicians' adherence to these tasks will track and ultimately increase treatment integrity. Thus, when the client-clinician relationship tracks and evaluates the three pillars of (1) stage/process change, (2) task acquisition, and (3) treatment integrity, the culmination of these efforts presents a new way of more sensitively measuring outcome in short-term psychotherapy. Data collection is suggested as a first step to empirically evaluate the testable hypotheses suggested within this current model. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message The
Johnson, Marcia K; Nolen-Hoeksema, Susan; Mitchell, Karen J; Levin, Yael
Using functional magnetic resonance imaging, we investigated neural activity associated with self-reflection in depressed [current major depressive episode (MDE)] and healthy control participants, focusing on medial cortex areas previously shown to be associated with self-reflection. Both the MDE and healthy control groups showed greater activity in anterior medial cortex (medial frontal gyrus, anterior cingulate gyrus) when cued to think about hopes and aspirations compared with duties and obligations, and greater activity in posterior medial cortex (precuneus, posterior cingulate) when cued to think about duties and obligations (Experiment 1). However, the MDE group showed less activity than controls in the same area of medial frontal cortex when self-referential cues were more ambiguous with respect to valence (Experiment 2), and less deactivation in a non-self-referential condition in both experiments. Furthermore, individual differences in rumination were positively correlated with activity in both anterior and posterior medial cortex during non-self-referential conditions. These results provide converging evidence for a dissociation of anterior and posterior medial cortex depending on the focus of self-relevant thought. They also provide neural evidence consistent with behavioral findings that depression is associated with disruption of positively valenced thoughts in response to ambiguous cues, and difficulty disengaging from self-reflection when it is appropriate to do so.
Shimizu, Fujio; Fujita, Jun-ichi
A cold metastable neon atomic beam was manipulated with a reflective amplitude hologram that was encoded on a silicon surface. A black-and-white pattern of atoms was reconstructed on a microchannel plate detector. The hologram used the enhanced quantum reflection developed by authors and was made of a two-dimensional array of rectangular low and high reflective cells. The surface of the high reflective cell was composed of regularly spaced roof-shaped ridges, while the low reflective cell was simply a flat surface. The hologram was the first demonstration of reflective atom-optical elements that used universal interaction between a neutral atom and solid surface
Han Li'na; Gu Ying; Liu Fanguang
Objective: To determine the changes of levels of plasma endothelin-1 (ET-1) and nitric oxide (NO) after intravenous photocoagulation of the varicosis of the greater saphenous vein. Methods: Fifty-eight patients with varicosis of greater saphenous vein were treated with intravenous photocoagulation. The levels of plasma ET-1 and NO were determined with radioimmunoassay and Griss method respectively on the 1st, 3rd, 7th and 14th day after the treatment. Another fifty-six patients with varicosis of greater saphenous vein were treated with the traditional high ligation and stripping method. The levels of ET-1 and NO on 1st, 3rd, 7th and 14th day postoperatively were also determined too. Results: The levels of ET-1 and NO, whether inphotocoagulation or traditional treatment group, increased at first, then decreased, approaching normal level finally. The peak levels of ET-1 and NO in photocoagulation group were lower than those in traditional method groups, reaching normal levels earlier. Conclusion: The levels of ET-1 and NO after treatment can reflect the intensity of stress and condition of recovery. (authors)
Eaton, Melody K
This study was designed to describe and evaluate the influence of a change in a Medicare reimbursement on the effectiveness of home health nursing care for stage III or greater decubitus ulcer patients. This health policy originated from the Balanced Budget Act (BBA) of 1997 and took its full effect with initiation of the Prospective Payment System (PPS) on October 1, 2000. A quantitative quasi-experimental design used OASIS data from the state of Virginia to evaluate 555 stage III or greater decubitus ulcer patients, age 65 or older. Comparisons were investigated between pre-PPS, 2000, and post-PPS, 2001, outcomes related to reported ulcer healing, lengths of stay, and discharge disposition. Results demonstrated significant differences for the outcomes studied. In addition, sanitation, ulcer healing, and discharge disposition were linked as predictors for length of stay. Results demonstrated that PPS has affected nursing care effectiveness for stage III or greater decubitus ulcer home health patients.
Bree, Laura; Gallagher, Barbara A; Shiel, Robert E; Mooney, Carmel T
Hyperthyroidism is common in older cats. Prevalence varies geographically, but is anecdotally considered low in Ireland. The aim of this study was to document prevalence of hyperthyroidism in older cats in the greater Dublin area of Ireland and to assess environmental and clinical associations for development and identification of the disease. Primary-care veterinary practices were requested to select cats aged 10 years or older where blood sampling was being performed for health screening or clinical investigations. Surplus serum/plasma samples were submitted to University College Dublin Diagnostic Endocrine Laboratory for total thyroxine (T 4 ) measurement. Cats were classified as hyperthyroid, equivocal or euthyroid based on a total T 4 concentration (reference interval, 15-60 nmol/L), of >60 nmol/L, 30-60 nmol/L or hyperthyroidism were excluded. A questionnaire completed by the client and veterinarian detailing historical and physical information was also required. Associations between categorical variables were analysed by Chi-square or Fisher's exact test and odds ratio (OR) calculated. A P value of hyperthyroid, 54 (10.6%) equivocal and 346 (68.2%) euthyroid. The presence of goitre ( P weight loss ( P hyperthyroidism. Cats with goitre were more likely to be diagnosed as hyperthyroid [OR 2.85, (95% CI 1.75-4.62] compared to those without. However, goitre was only palpated in 40 of 102 (39.2%) hyperthyroid cats. Increasing age was the only significant ( P hyperthyroidism. A relationship between hyperthyroidism and sex, breed, lifestyle, parasite control, vaccination status or feeding habits was not identified. Hyperthyroidism is not uncommon in Irish cats. Age was the only significant risk factor for its development. The high proportion of hyperthyroid cats without palpable goitre (> 60%) may reflect failure to detect goitre and account for the perceived low prevalence of this condition in Ireland.
Phillips, R.; Craig, M.; Turner, B. L.; Liang, C.
Climate predicts soil organic matter (SOM) stocks at the global scale, yet controls on SOM stocks at finer spatial scales are still debated. A current hypothesis predicts that carbon (C) and nitrogen (N) storage in soils should be greater when decomposition is slow owing to microbial competition for nutrients or the recalcitrance of organic substrates (hereafter the `slow decay' hypothesis). An alternative hypothesis predicts that soil C and N storage should be greater in soils with rapid decomposition, owing to the accelerated production of microbial residues and their stabilization on soil minerals (hereafter the `stabilization hypothesis'). To test these alternative hypotheses, we quantified soil C and N to 1-m depth in temperate forests across the Eastern and Midwestern US that varied in their biotic, climatic, and edaphic properties. At each site, we sampled (1) soils dominated by arbuscular mycorrhizal (AM) tree species, which typically have fast decay rates and accelerated N cycling, (2) soils dominated by ectomycorrhizal (ECM) tree species, which generally have slow decay rates and slow N cycling, and (3) soils supporting both AM and ECM trees. To the extent that trees and theor associated microbes reflect and reinforce soil conditions, support for the slow decay hypothesis would be greater SOM storage in ECM soils, whereas support for the stabilization hypothesis would be greater SOM storage in AM soils. We found support for both hypotheses, as slow decomposition in ECM soils increased C and N storage in topsoil, whereas fast decomposition in AM soils increased C and N storage in subsoil. However, at all sites we found 57% greater total C and N storage in the entire profile in AM- soils (P stabilization hypothesis. Amino sugar biomarkers (an indicator of microbial necromass) and particle size fractionation revealed that the greater SOM storage in AM soils was driven by an accumulation of microbial residues on clay minerals and metal oxides. Taken together
Faroa Brendon Duran
Full Text Available Student engagement has been defined as the extent to which students are engaged in activities that higher education research has shown to be linked with high-quality learning outcomes. The ubiquitous influence of the term ‘student engagement’ has been felt throughout the higher education landscape. This is especially true for South African higher education where student success has been poor. South African universities have been tasked to improve the student learning experience as a component of improving success. Some of the innovative teaching and learning practices often highlighted by research which are thought to improve student engagement include: having students adopt teaching roles such as peer assessment, tutoring and mentoring. These practices are thought to promote student engagement, leading to greater student academic success. Tutoring can therefore be seen as one of the key strategies to facilitate student engagement in order to achieve academic success. The following paper considers the role of tutoring in student engagement while reflecting on strategies used at a South African university to address the challenges associated with student success.
Clegg, R. N.; Jolliff, B. L.; Robinson, M. S.; Hapke, B. W.; Plescia, J. B.
areas; this magnitude is the same, within uncertainty, for all sites, indicating a common process or combination of processes causing differences in reflectance properties of the regolith. Phase-ratio images and photometric data collected over a range of illumination geometries show that a greater separation in reflectance occurs between the HR-BZs and undisturbed areas with increasing phase angle and indicate that the HR-BZs are less backscattering than undisturbed areas. As working hypotheses, we consider the following possibilities to explain BZ reflectance phenomena: change in macroscopic roughness, microscopic modification of surface structure, redistribution of fines (excavation from LR-BZ and deposition in HR-BZ), change in compaction, contamination from fuel, and modification of maturity. The LR-BZ is affected by macroscopic disruption of the surface and increased shadowing. We infer that HR-BZ reflectance has been affected by scouring from particles entrained by exhaust gases with low-angle trajectories. Entrained particles with trajectories greater than a few degrees relative to horizontal travel well beyond the BZ boundary and do not contribute to BZ reflectance variations. Regolith particle interactions with surface soil within HR-BZs may destroy fine-scale surface structure (e.g., "fairy-castle") and decrease macroscopic roughness, contributing to a decrease in backscattering character within the HR-BZ.
Konopacki, Steven; Akbari, Hashem
In 2000, the Toronto Atmospheric Fund (TAF) embarked on an initiative to quantify the potential benefits of Heat Island Reduction (HIR) strategies (shade trees, reflective roofs and pavements) in reducing cooling energy use in buildings, lowering the ambient air temperature and improve air quality. This report summarizes the efforts of Lawrence Berkeley National Laboratory (LBNL) to assess the impacts of HIR measures on building cooling- and heating-energy use. We discuss our efforts to calculate annual energy savings and peak-power avoidance of HIR strategies in the building sector of the Greater Toronto Area. The analysis is focused on three major building types that offer most saving potentials: residence, office and retail store. Using an hourly building energy simulation model, we quantify the energy saving potentials of (1) using cool roofs on individual buildings[direct effect], (2) planting deciduous shade trees near south and west walls of building[direct effect], (3) planting coniferous wind-shielding vegetation near building[direct effect], (4) ambient cooling by a large-scale program of urban reforestation with reflective building roofs and pavements[indirect effect], (5) and the combined direct and indirect effects. Results show potential annual energy savings of over$11M (with uniform residential and commercial electricity and gas prices of$0.084/kWh and$5.54/GJ) could be realized by ratepayers from the combined direct and indirect effects of HIR strategies. Of that total, about 88 percent was from the direct impact roughly divided equally among reflective roofs, shade trees and wind-shielding, and the remainder (12 percent) from the indirect impact of the cooler ambient air temperature. The residential sector accounts for over half (59 percent) of the total, offices 13 percent and retail stores 28 percent. Savings from cool roofs were about 20 percent, shade trees 30 percent, wind shielding of tree 37 percent, and indirect effect 12 percent. These
Marciano, Déborah; Bentin, Shlomo; Deouell, Leon Y
After choosing between uncertain options, one might get feedback on both the outcome of the chosen option and the outcome of the unchosen option (the alternative). Behavioral research has shown that in such cases people engage in outcome comparison, and that the alternative outcome influences the way one evaluates his own received outcome. Moreover, this influence differs whether one was responsible or not for the choice made. In two studies, we looked for the electrophysiological correlates of outcome comparison. Subjects chose one of two boxes shown on the screen, each box contained a gain or a loss. The alternative outcome was always revealed first, followed by the received outcome. In half of the trials the software picked one box instead of subjects. We tested whether the feedback-related negativity (FRN) and the P3 elicited by the received reflect outcome comparison. As expected, we found that the FRN and P3 were more positive when the received outcome was a gain (vs. a loss). The FRN and P3 were also sensitive to the value of the alternative outcome, but contrary to our predictions, they were more positive when the alternative outcome was a gain (vs. a loss). As the FRN and P3 are sensitive to expectations, we hypothesized that our findings might result from subjects' biased expectations: subjects might have wrongly believed that a good (bad) alternative outcome signaled a bad (good) received outcome. This hypothesis, coined as the Alternative Omen Effect, was confirmed in parallel in a series of behavioral experiments: people see an illusory negative correlation between the uncorrelated outcomes of choice options (reported in Marciano-Romm et al. (2016)). A challenge for future research will be to disentangle the effects of expectation from those of outcome comparison. Copyright © 2018 Elsevier Ltd. All rights reserved.
We investigate the question of whether the entropy and the Renyi entropies of the vacuum state reduced to a region of space can be represented in terms of correlators in quantum field theory. In this case, the positivity relations for the correlators are mapped into inequalities for the entropies. We write them using a real-time version of reflection positivity, which can be generalized to general quantum systems. Using this generalization we can prove an infinite sequence of inequalities which are obeyed by the Renyi entropies of integer index. There is one independent inequality involving any number of different subsystems. In quantum field theory the inequalities acquire a simple geometrical form and are consistent with the integer index Renyi entropies being given by vacuum expectation values of twisting operators in the Euclidean formulation. Several possible generalizations and specific examples are analyzed
Borrell-Carrió, F; Hernández-Clemente, J C
The purpose of this article is to analyze some models of expert decision and their impact on the clinical practice. We have analyzed decision-making considering the cognitive aspects (explanatory models, perceptual skills, analysis of the variability of a phenomenon, creating habits and inertia of reasoning and declarative models based on criteria). We have added the importance of emotions in decision making within highly complex situations, such as those occurring within the clinical practice. The quality of the reflective act depends, among other factors, on the ability of metacognition (thinking about what we think). Finally, we propose an educational strategy based on having a task supervisor and rectification scenarios to improve the quality of medical decision making. Copyright © 2013 Elsevier España, S.L. All rights reserved.
This and twelve previous Symposia reflect the evolution of microdosimetry, a field of research that has determined major new developments in radiation research, radiation protection, and radiology during the past four decades. The concepts of microdosimetry and its techniques were developed almost single handedly by H.H. Rossi. This memorial lecture outlines some of the ideas and some of the work of Harald Rossi that led to microdosimetry. It describes its major impact on radiobiology and, especially, its impact on studies with fast neutrons and on risk assessment. Microdosimetry was primarily designed as a tool for the elucidation of basic mechanisms of radiation action, but it has found its most important applications in the dosimetric measurement techniques that have become indispensable in radiation protection and in the dosimetry for radiation therapy. The advances of molecular biology are now providing new possibilities for a quantitative application of microdosimetry to radiobiology along the lines that Harald Rossi defined. (author)
Diez, Thomas; Manners, Ian James
-interested geographical expansion or military superiority. In the 1970s, François Duchêne called it a ‘civilian power’ (1972: 43); in the early 2000s it was argued that the label ‘normative power’ would be better suited (Manners 2000, 2002). Just as Duchêne’s civilian power reflected the Cold War milieu of the 1970s......There is a widespread belief that the European Union (EU) is a novel kind of power not only in its own institutional set-up but also in its external relations. It is said to rely on civilian rather than military means and to pursue the spread of particular norms rather than self......, the normative power approach signified a crystallisation of the EU in the post-Cold War era....
Dissing, Bjørn Skovlund; Clemmensen, Line Katrine Harder; Ersbøll, Bjarne Kjær
Quality control in the food industry is often performed by measuring various chemical compounds of the food involved. We propose an imaging concept for acquiring high quality multispectral images to evaluate changes of carrots and celeriac over a period of 14 days. Properties originating...... in the surface chemistry of vegetables may be captured in an integrating sphere illumination which enables the creation of detailed surface chemistry maps with a good combination of spectral and spatial resolutions. Prior to multispectral image recording, the vegetables were prefried and frozen at -30Â......°C for four months. During the 14 days of image recording, the vegetables were kept at +5Â°C in refrigeration. In this period, surface changes and thereby reflectance properties were very subtle. To describe this small variation we employed advanced statistical techniques to search a large featurespace...
Niebauer, Christopher Lee
Previous research found that mixed handers (i.e., those that are more ambidextrous) were more likely than strong handers to update their beliefs (Niebauer, Aselage, & Schutte, 2002). It was assumed that this was due to greater degrees of communication between the two cerebral hemispheres in mixed handers. Niebauer and Garvey (2004) made connections between this model of updating beliefs and metacognitive processing. The current work proposes that variations in interhemispheric interaction (as measured by degree of handedness) contribute to differences in consciousness, specifically when consciousness is used in rumination versus the metacognitive task of self-reflection. Using the Rumination-Reflection Questionnaire (Trapnell & Campbell, 1999), predictions were supported such that strong handedness was associated with self-rumination; whereas, mixed handedness was associated with increased self-reflection p valuesmetacognition, updating beliefs, and self-reflection. Several studies are reviewed suggesting that mixed handers experience fringe consciousness to a greater degree than strong handers.
Grant, Andrew J; Vermunt, Jan D; Kinnersley, Paul; Houston, Helen
be viewed alongside the high validity afforded by the authenticity of the learning tasks (compared with a sample of a student's learning taken by an exam question). Validity is enhanced by the rating scale which directly connects the grade given with intended learning outcomes. The moderate inter-rater reliability may be increased if a portfolio is completed over a longer period of time and contains more component pieces of work. The questionnaire used in this study only accessed limited information about the effect of reflection on students' learning. Qualitative methods of evaluation would determine the students experience in greater depth. It would be useful to evaluate the effects of reflective learning after students have had more time to get used to this unfamiliar method of learning and to overcome any problems in understanding the task.
Jenkins, Tom; Andersen, Kristina; Gaver, Bill
of attending to its made-material outcomes. The premise of this workshop is simple: We need additional social spaces and platforms for interacting with and reflecting upon material design outcomes at CHI. The goal of this workshop is to keep experimenting with such a space, with an emphasis on how prototyping...
Holm, Claus; Steenholdt, Niels
In this paper we use a learner perspective on learning outcomes which reflects that some students taking accounting classes are also provided with on-the-job training in accounting firms. Hence knowledge about learning outcomes for different groups of students is essential information for educators...
Aksenov, V.L.; Ignatovich, V.K.; Nikitenko, Yu.V.
Analytical solution for neutron reflection and transmission of magnetic mirrors with helicoidal magnetization is found. The dependence of neutron speed of reflection and transmission curves is shown. Resonant properties of helicoidal systems are found
Mamede, Silvia; Schmidt, Henk G.
Purpose: Reflection in medical diagnosis has been said to prevent errors by minimizing flaws in clinical reasoning. This claim, however, has been much disputed. While some studies show reflective reasoning to improve diagnostic performance, others find it to add nothing. This paper presents a narrative review of the literature on reflection in medical diagnosis aimed at addressing two questions: (1) how reflective reasoning has been conceived in this literature; and (2) what is the effect of ...
Gertsen, Frank; Lervang, Johan-Ulrik; Maack, Karl
Our main aim is to facilitate a reflective methodology for MSc thesis students in practical entrepreneurship that draws on the ideas of ‘reflection-in-action’ while simultaneously making use of the effectuation logics.......Our main aim is to facilitate a reflective methodology for MSc thesis students in practical entrepreneurship that draws on the ideas of ‘reflection-in-action’ while simultaneously making use of the effectuation logics....
Newton, Ryan J; McLellan, Sandra L; Dila, Deborah K; Vineis, Joseph H; Morrison, Hilary G; Eren, A Murat; Sogin, Mitchell L
Molecular characterizations of the gut microbiome from individual human stool samples have identified community patterns that correlate with age, disease, diet, and other human characteristics, but resources for marker gene studies that consider microbiome trends among human populations scale with the number of individuals sampled from each population. As an alternative strategy for sampling populations, we examined whether sewage accurately reflects the microbial community of a mixture of stool samples. We used oligotyping of high-throughput 16S rRNA gene sequence data to compare the bacterial distribution in a stool data set to a sewage influent data set from 71 U.S. cities. On average, only 15% of sewage sample sequence reads were attributed to human fecal origin, but sewage recaptured most (97%) human fecal oligotypes. The most common oligotypes in stool matched the most common and abundant in sewage. After informatically separating sequences of human fecal origin, sewage samples exhibited ~3× greater diversity than stool samples. Comparisons among municipal sewage communities revealed the ubiquitous and abundant occurrence of 27 human fecal oligotypes, representing an apparent core set of organisms in U.S. populations. The fecal community variability among U.S. populations was significantly lower than among individuals. It clustered into three primary community structures distinguished by oligotypes from either: Bacteroidaceae, Prevotellaceae, or Lachnospiraceae/Ruminococcaceae. These distribution patterns reflected human population variation and predicted whether samples represented lean or obese populations with 81 to 89% accuracy. Our findings demonstrate that sewage represents the fecal microbial community of human populations and captures population-level traits of the human microbiome. The gut microbiota serves important functions in healthy humans. Numerous projects aim to define a healthy gut microbiome and its association with health states. However
Allen, Elizabeth S; Post, Kristina M; Markman, Howard J; Rhoades, Galena K; Stanley, Scott M
After completing a relationship education program, collecting participant evaluations of the program is common practice. These are generally used as an index of "consumer satisfaction" with the program, with implications for feasibility and quality. Rarely have these ratings been used as predictors of changes in marital quality, although such feedback may be the only data providers collect or have immediate access to when considering the success of their efforts. To better understand the utility of such ratings to predict outcomes, we evaluated links between participant ratings and changes in self-reported marital satisfaction and communication scores one year later for a sample of 191 Army couples who had participated in a relationship education program delivered by Army chaplains (PREP for Strong Bonds). Overall ratings of general satisfaction with the program and the leader did not predict changes in marital outcomes one year later, whereas higher ratings of how much was learned, program helpfulness, increased similarity in outlook regarding Army life, and helpfulness of communication skills training predicted greater change in communication skills one year later. Higher ratings of items reflecting intent to invest more time in the relationship, and increased confidence in constructive communication and working as a team with the spouse predicted greater increases in both marital satisfaction and communication skills one year later. The constructs of intention and confidence (akin to perceived behavioral control) suggest that the Theory of Planned Behavior may be particularly useful when considering which Army couples will show ongoing benefit after relationship education.
Hayes, Jacqueline F; Altman, Myra; Kolko, Rachel P; Balantekin, Katherine N; Holland, Jodi Cahill; Stein, Richard I; Saelens, Brian E; Welch, R Robinson; Perri, Michael G; Schechtman, Kenneth B; Epstein, Leonard H; Wilfley, Denise E
Food fussiness (FF), or the frequent rejection of both familiar and unfamiliar foods, is common among children and, given its link to poor diet quality, may contribute to the onset and/or maintenance of childhood obesity. This study examined child FF in association with anthropometric variables and diet in children with overweight/obesity participating in family-based behavioral weight loss treatment (FBT). Change in FF was assessed in relation to FBT outcome, including whether change in diet quality mediated the relation between change in FF and change in child weight. Child (N = 170; age = 9.41 ± 1.23) height and weight were measured, and parents completed FF questionnaires and three 24-h recalls of child diet at baseline and post-treatment. Healthy Eating Index-2005 scores were calculated. At baseline, child FF was related to lower vegetable intake. Average child FF decreased from start to end of FBT. Greater decreases in FF were associated with greater reductions in child body mass index and improved overall diet quality. Overall, diet quality change through FBT mediated the relation between child FF change and child body mass index change. Children with high FF can benefit from FBT, and addressing FF may be important in childhood obesity treatment to maximize weight outcomes. © 2016 The Obesity Society.
Pinkham, Amy E; Harvey, Philip D; Penn, David L
Paranoia is a common symptom of schizophrenia that may be related to how individuals process and respond to social stimuli. Previous investigations support a link between increased paranoia and greater social cognitive impairments, but these studies have been limited to single domains of social cognition, and no studies have examined how paranoia may influence functional outcome. Data from 147 individuals with schizophrenia were used to examine whether actively paranoid and non-paranoid individuals with schizophrenia differ in social cognition and functional outcomes. On measures assessing social cognitive bias, paranoid individuals endorsed more hostile and blaming attributions and identified more faces as untrustworthy; however, paranoid and non-paranoid individuals did not differ on emotion recognition and theory of mind tasks assessing social cognitive ability. Likewise, paranoid individuals showed greater impairments in real-world interpersonal relationships and social acceptability as compared to non-paranoid patients, but these differences did not extend to performance based tasks assessing functional capacity and social competence. These findings isolate specific social cognitive disparities between paranoid and non-paranoid subgroups and suggest that paranoia may exacerbate the social dysfunction that is commonly experienced by individuals with schizophrenia.
Hammer, D.K.; Reymen, I.M.M.J.; Mcdonagh, Deana; Hekkert, Paul; Van Erp, Jeroen; Gyi, Diane
Reflection on design processes performed by designers is called design reflection. In our view, this kind of reflection aims at answering essential questions like “Is my design answering the stakeholder concerns?”, “Am I solving the essential problems or am I wasting time on irrelevant aspects?”,
Grigoriadou, Maria; Tsaganou, Grammatiki; Cavoura, Theodora
The Reflective Tutorial Dialogue System (ReTuDiS) is a system for learner modelling historical text comprehension through reflective dialogue. The system infers learners' cognitive profiles and constructs their learner models. Based on the learner model the system plans the appropriate--personalized for learners--reflective tutorial dialogue in…
Oosterbaan, Anne E.; van der Schaaf, Marieke F.; Baartman, Liesbeth K. J.; Stokking, Karel M.
This study aims to explore the relationship between the occurrence of reflection (and non-reflection) and thinking activities (e.g., orientating, selecting, analysing) during portfolio-based conversations. Analysis of 21 transcripts of portfolio-based conversations revealed that 20% of the segments were made up of reflection (content reflection…
Paxton, Joseph M.; Ungar, Leo; Greene, Joshua D.
While there is much evidence for the influence of automatic emotional responses on moral judgment, the roles of reflection and reasoning remain uncertain. In Experiment 1, we induced subjects to be more reflective by completing the Cognitive Reflection Test (CRT) prior to responding to moral dilemmas. This manipulation increased utilitarian…
Melin, R; Jirari, H; Peysson, S
We propose toy models of crossed Andreev reflection in multiterminal hybrid structures containing out-of-equilibrium conductors. We apply the description to two possible experiments: (i) to a device containing a large quantum dot inserted in a crossed Andreev reflection circuit, and (ii) to a device containing an Aharonov-Bohm loop inserted in a crossed Andreev reflection circuit
Pearson, Margot; Kayrooz, Carole
This paper describes the development of an instrument--The Reflective Supervisor Questionnaire (RSQ). The RSQ maps the domain of research supervisory practice as a facilitative process involving educational tasks and activities. It is designed to assist research supervisors explore, by means of self-reflection and reflection on feedback from…
Lindroth, James T.
The use of reflective journals has been identified as an effective tool to promote reflection in preservice teachers. This review of literature provides the reader with an understanding of the various ways journals are used and assessed in teacher education programs. The findings of this review outline the use of reflective journals on topics such…
Reflection and collaboration are two activities teachers can use to change and improve their practice. However, finding the time and space to do so can be challenging. The collaborative reflective teaching cycle is a structured activity teachers can use to engage in reflection and collaboration. This article describes how a seventh grade teaching…
Reinholz, Daniel L.
This paper focuses on reflection in learning mathematical practices. While there is a long history of research on reflection in mathematics, it has focused primarily on the development of conceptual understanding. Building on notion of learning as participation in social practices, this paper broadens the theory of reflection in mathematics…
Lotter, Christine R.; Miller, Cory
In this paper, we explore middle school science teachers' learning of inquiry-based instructional strategies through reflection on practice teaching sessions during a summer enrichment program with middle level students. The reflection sessions were part of a larger year-long inquiry professional development program in which teachers learned science content and inquiry pedagogy. The program included a 2-week summer institute in which teachers participated in science content sessions, practice teaching to middle level students, and small group-facilitated reflection sessions on their teaching. For this study, data collection focused on teachers' recorded dialogue during the facilitator - run reflection sessions, the teachers' daily written reflections, a final written reflection, and a written reflection on a videotaped teaching session. We investigated the teachers' reflection levels and the themes teachers focused on during their reflection sessions. Teachers were found to reflect at various reflection levels, from simple description to a more sophisticated focus on how to improve student learning. Recurrent themes point to the importance of providing situated learning environments, such as the practice teaching with immediate reflection for teachers to have time to practice new instructional strategies and gain insight from peers and science educators on how to handle student learning issues.
Furuya, K.; Zimerman, A.H.; Villani, A.
Families of superconvergent relations for the normal reflectivity function are written. Sum rules connecting the difference of phases of the reflectivities of two materials are also considered. Finally superconvergence relations and sum rules for magneto-reflectivity in the Faraday and Voigt regimes are also studied
van der Molen, Thys; Cazzola, Mario
Bronchodilators are central to the management of chronic obstructive pulmonary disease (COPD). Clinical studies combining different classes of bronchodilators, in particular a long-acting muscarinic antagonist (LAMA) and a long-acting β2-agonist (LABA), have demonstrated greater improvements in lung function (forced expiratory volume in 1 second, FEV1) in patients with COPD than monotherapy. FEV1 has served as an important diagnostic measurement of COPD, and the majority of clinical studies of currently available pharmacotherapies grade effectiveness of treatment regimens based on improvements in FEV1. However, FEV1 alone may not adequately reflect the overall health status of the patient. Published evidence suggests that LABA/LAMA combination therapies demonstrate greater improvements in patient-centred outcomes such as dyspnoea, symptoms, rescue medication use, and quality of life than individual drugs used alone. Evaluating patient-centred outcomes associated with COPD is likely to play an important role in future research as a measure of overall treatment effectiveness. Raising awareness of the importance of outcomes beyond lung function alone, particularly in primary care where most patients initially present themselves for medical evaluation, should form a fundamental part of a more holistic approach to COPD management.
von Borries, A K L; Verkes, R J; Bulten, B H; Cools, R; de Bruijn, E R A
Optimal behavior depends on the ability to assess the predictive value of events and to adjust behavior accordingly. Outcome processing can be studied by using its electrophysiological signatures--that is, the feedback-related negativity (FRN) and the P300. A prominent reinforcement-learning model predicts an FRN on negative prediction errors, as well as implying a role for the FRN in learning and the adaptation of behavior. However, these predictions have recently been challenged. Notably, studies so far have used tasks in which the outcomes have been contingent on the response. In these paradigms, the need to adapt behavioral responses is present only for negative, not for positive feedback. The goal of the present study was to investigate the effects of positive as well as negative violations of expectancy on FRN amplitudes, without the usual confound of behavioral adjustments. A reversal-learning task was employed in which outcome value and outcome expectancy were orthogonalized; that is, both positive and negative outcomes were equally unexpected. The results revealed a double dissociation, with effects of valence but not expectancy on the FRN and, conversely, effects of expectancy but not valence on the P300. While FRN amplitudes were largest for negative-outcome trials, irrespective of outcome expectancy, P300 amplitudes were largest for unexpected-outcome trials, irrespective of outcome valence. These FRN effects were interpreted to reflect an evaluation along a good-bad dimension, rather than reflecting a negative prediction error or a role in behavioral adaptation. By contrast, the P300 reflects the updating of information relevant for behavior in a changing context.
Ross, Paula T; Lypson, Monica L
Physician bias toward patients directly impacts patient care and health outcomes. However, too little research has been done investigating avenues to bring about self-awareness in this area to eliminate commonly held stereotypes that fuel physician bias. The purpose of this study was to explore the ways in which 2nd-year medical students' reflected on an artistic-narrative presentation given by a woman with sickle cell disease. A total of 320 2nd-year medical student essays were reviewed for content relevant to the artistic-narrative presentation. A total of 75 essays were identified and served as the data for this study. These 75 essays were analyzed using qualitative interpretive thematic content analysis to identify students' perceptions and reflections on culture in the healthcare environment and the patient-provider relationship. The analysis of the reflective essays revealed that this exercise helped students acknowledge physician bias in pain treatment, foster empathetic views toward patients as individuals, and recognize various ways in which biased beliefs can provide incite in healthcare disparities. These findings suggest that the combination of methods--art, narrative, and written reflection--helped students acknowledge their own bias as well as the ways in which taken-for-granted assumptions and biases can influence patient care.
Wawrzyniak, Andrew J; Hamer, Mark; Steptoe, Andrew; Endrighi, Romano
Cardiovascular (CV) responses to mental stress are prospectively associated with poor CV outcomes. The association between CV responses to mental stress and reaction times (RTs) in aging individuals may be important but warrants further investigation. The present study assessed RTs to examine associations with CV responses to mental stress in healthy, older individuals using robust regression techniques. Participants were 262 men and women (mean age = 63.3 ± 5.5 years) from the Whitehall II cohort who completed a RT task (Stroop) and underwent acute mental stress (mirror tracing) to elicit CV responses. Blood pressure, heart rate, and heart rate variability were measured at baseline, during acute stress, and through a 75-min recovery. RT measures were generated from an ex-Gaussian distribution that yielded three predictors: mu-RT, sigma-RT, and tau-RT, the mean, standard deviation, and mean of the exponential component of the normal distribution, respectively. Decreased intraindividual RT variability was marginally associated with greater systolic (B = -.009, SE = .005, p = .09) and diastolic (B = -.004, SE = .002, p = .08) blood pressure reactivity. Decreased intraindividual RT variability was associated with impaired systolic blood pressure recovery (B = -.007, SE = .003, p = .03) and impaired vagal tone (B = -.0047, SE = .0024, p = .045). Study findings offer tentative support for an association between RTs and CV responses. Despite small effect sizes and associations not consistent across predictors, these data may point to a link between intrinsic neuronal plasticity and CV responses. © 2016 The Authors. Psychophysiology published by Wiley Periodicals, Inc. on behalf of Society for Psychophysiological Research.
Moses, Kelvin A; Winer, Andrew; Sfakianos, John P; Poon, Stephen A; Kent, Matthew; Bernstein, Melanie; Russo, Paul; Dalbagni, Guido
Penile cancer is a rare malignancy, and few guidelines are available to define treatment paradigms. For greater understanding of the natural history of surgically treated penile cancer, we analyzed the experience at our institution. Using an institutional database, we identified 127 patients treated for squamous cell carcinoma of the penis from 1995-2011. Cancer-specific survival (CSS) was calculated using the Kaplan-Meier method. Survival data were compared using the log-rank test. The difference in risk of cancer-specific death by lymph node status and histological grade was determined by univariate Cox regression analysis. Five year CSS for pTis, pT1, pT2, and pT3/4 was 100%, 84% (95% CI 58%-95%), 54% (95% CI 33%-71%), and 54% (95% CI 25%-76%), respectively (p ≤ .005). Three year CSS for patients with N0, N+, and Nx disease was 90% (95% CI 47%-99%), 65% (95% CI 47%-79%), and 86% (95% CI 73%-93%), respectively (p = .03). The receipt of neoadjuvant chemotherapy did not change per 5 year period over the 16 years of our study. Median follow up was 2.8 years. Penile cancer patients with advanced disease had poor survival. Tumor stage and nodal status were significant predictors of CSS. Penis-sparing approaches may be considered for most patients; however, pathological stage and grade dictate the management and ultimate outcome. Further studies are necessary to clarify the benefits of chemotherapy in this disease.
Boyle Malcolm J
Full Text Available Abstract Background Suboptimal bag ventilation in cardiopulmonary resuscitation (CPR has demonstrated detrimental physiological outcomes for cardiac arrest patients. In light of recent guideline changes for resuscitation, there is a need to identify the efficacy of bag ventilation by prehospital care providers. The objective of this study was to evaluate bag ventilation in relation to operator ability to achieve guideline consistent ventilation rate, tidal volume and minute volume when using two different capacity self-inflating bags in an undergraduate paramedic cohort. Methods An experimental study using a mechanical lung model and a simulated adult cardiac arrest to assess the ventilation ability of third year Monash University undergraduate paramedic students. Participants were instructed to ventilate using 1600 ml and 1000 ml bags for a length of two minutes at the correct rate and tidal volume for a patient undergoing CPR with an advanced airway. Ventilation rate and tidal volume were recorded using an analogue scale with mean values calculated. Ethics approval was granted. Results Suboptimal ventilation with the use of conventional 1600 ml bag was common, with 77% and 97% of participants unable to achieve guideline consistent ventilation rates and tidal volumes respectively. Reduced levels of suboptimal ventilation arouse from the use of the smaller bag with a 27% reduction in suboptimal tidal volumes (p = 0.015 and 23% reduction in suboptimal minute volumes (p = 0.045. Conclusion Smaller self-inflating bags reduce the incidence of suboptimal tidal volumes and minute volumes and produce greater guideline consistent results for cardiac arrest patients.
Moses, Kelvin A.; Winer, Andrew; Sfakianos, John P.; Poon, Stephen A.; Kent, Matthew; Bernstein, Melanie; Russo, Paul; Dalbagni, Guido
Introduction Penile cancer is a rare malignancy, and few guidelines are available to define treatment paradigms. For greater understanding of the natural history of surgically treated penile cancer, we analyzed experience at our institution. Materials and Methods Using an institutional database, we identified 127 patients treated for squamous cell carcinoma of the penis from 1995 – 2011. Cancer-specific survival (CSS) was calculated using the Kaplan-Meier method. Survival data were compared using the log-rank test. The difference in risk of cancer-specific death by lymph node status and histological grade was determined by univariate Cox regression analysis. Results Five-year CSS for pTis, pT1, pT2, and pT3/4 was 100%, 84% (95% CI 58%-95%), 54% (95% CI 33%-71%), and 54% (95% CI 25%-76%), respectively (P ≤ .005). Three-year CSS for patients with N0, N+, and Nx disease was 90% (95% CI 47%-99%), 65% (95% CI 47%-79%), and 86% (95% CI 73%-93%), respectively (P = .03). The receipt of neoadjuvant chemotherapy did not change per 5 year period over the 16 years of our study. Median follow-up was 2.8 years. Conclusions Penile cancer patients with advanced disease had poor survival. Tumor stage and nodal status were significant predictors of CSS. Penis-sparing approaches may be considered for most patients; however, pathological stage and grade dictate the management and ultimate outcome. Further studies are necessary to clarify the benefits of chemotherapy in this disease. PMID:24775572
Full Text Available The aim of the study was to investigate the efficacy of greater trochanteric fixation using a multifilament cable to ensure abductor lever arm continuity in patients with a proximal femoral fracture undergoing partial hip arthroplasty. Mean age of the patients (12 men, 20 women was 84.12 years. Mean follow-up was 13.06 months. Fixation of the dislocated greater trochanter with or without a cable following load application was assessed by finite element analysis (FEA. Radiological evaluation was based on the distance between the fracture and the union site. Harris hip score was used to evaluate final results: outcomes were excellent in 7 patients (21.8%, good in 17 patients (53.1%, average in 5 patients (15.6%, and poor in 1 patient (9.3%. Mean abduction angle was 20.21°. Union was achieved in 14 patients (43.7%, fibrous union in 12 (37.5%, and no union in 6 (18.7%. FEA showed that the maximum total displacement of the greater trochanter decreased when the fractured bone was fixed with a cable. As the force applied to the cable increased, the displacement of the fractured trochanter decreased. This technique ensures continuity of the abductor lever arm in patients with a proximal femoral fracture who are undergoing partial hip arthroplasty surgery.
Ozan, Fırat; Koyuncu, Şemmi; Pekedis, Mahmut; Altay, Taşkın; Yıldız, Hasan; Toker, Gökhan
The aim of the study was to investigate the efficacy of greater trochanteric fixation using a multifilament cable to ensure abductor lever arm continuity in patients with a proximal femoral fracture undergoing partial hip arthroplasty. Mean age of the patients (12 men, 20 women) was 84.12 years. Mean follow-up was 13.06 months. Fixation of the dislocated greater trochanter with or without a cable following load application was assessed by finite element analysis (FEA). Radiological evaluation was based on the distance between the fracture and the union site. Harris hip score was used to evaluate final results: outcomes were excellent in 7 patients (21.8%), good in 17 patients (53.1%), average in 5 patients (15.6%), and poor in 1 patient (9.3%). Mean abduction angle was 20.21°. Union was achieved in 14 patients (43.7%), fibrous union in 12 (37.5%), and no union in 6 (18.7%). FEA showed that the maximum total displacement of the greater trochanter decreased when the fractured bone was fixed with a cable. As the force applied to the cable increased, the displacement of the fractured trochanter decreased. This technique ensures continuity of the abductor lever arm in patients with a proximal femoral fracture who are undergoing partial hip arthroplasty surgery. PMID:25177703
Rankin, Arturo; Matthies, Larry; Bellutta, Paolo
A water body s surface can be modeled as a horizontal mirror. Water detection based on sky reflections and color variation are complementary. A reflection coefficient model suggests sky reflections dominate the color of water at ranges > 12 meters. Water detection based on sky reflections: (1) geometrically locates the pixel in the sky that is reflecting on a candidate water pixel on the ground (2) predicts if the ground pixel is water based on color similarity and local terrain features. Water detection has been integrated on XUVs.
This book deals with the reflection of electromagnetic and particle waves by interfaces. The interfaces can be sharp or diffuse. The topics of the book contain absorption, inverse problems, anisotropy, pulses and finite beams, rough surfaces, matrix methods, numerical methods, reflection of particle waves and neutron reflection. Exact general results are presented, followed by long wave reflection, variational theory, reflection amplitude equations of the Riccati type, and reflection of short waves. The Second Edition of the Theory of Reflection is an updated and much enlarged revision of the 1987 monograph. There are new chapters on periodically stratified media, ellipsometry, chiral media, neutron reflection and reflection of acoustic waves. The chapter on anisotropy is much extended, with a complete treatment of the reflection and transmission properties of arbitrarily oriented uniaxial crystals. The book gives a systematic and unified treatment reflection and transmission of electromagnetic and particle...
Aronson, Louise; Niehaus, Brian; DeVries, Charlie D; Siegel, Jennifer R; O'Sullivan, Patricia S
Increasingly, students are asked to write reflections as part of their medical education, but some question the influence of other factors on the evaluation of these reflections. In this pilot study, the investigators determined whether scores from a validated rubric to measure reflective ability were affected by irrelevant variance resulting from writing or storytelling ability. Students in clerkships wrote reflections on professionalism. All were given identical prompts, with half receiving additional structured guidelines on reflection. Sixty reflections, 30 from each group, were randomly chosen and scored for reflection, writing, and storytelling by trained raters using validated rubrics. There was no correlation between reflection and either writing (r = 0.049, P = .35) or storytelling (r = 0.14, P = .13). The guidelines increased reflection, but not writing or storytelling scores. Reflection is a distinct construct unaffected by learners' writing or storytelling skills. These findings support reflective ability as a distinct skill.
Stephens, Mark B; Reamy, Brian V; Anderson, Denise; Olsen, Cara; Hemmer, Paul A; Durning, Steven J; Auster, Simon
Finding ways to improve communication and self-reflection skills is an important element of medical education and continuing professional development. This study examines the relationship between self-reflection and educational outcomes. We correlate performance in a preclinical course that focuses on self-reflection as it relates to contextual elements of patient care (Human Context of Health Care), with educational measures such as overall grade point average, clinical clerkship scores, and Medical College Admission Test (MCAT) scores. Student performance in Human Context of Health Care correlated with MCAT-Verbal scores, MCAT-writing sample scores, clerkship grades, and overall medical school grade point average (R = 0.3; p self-reflection skills are often neglected in undergraduate medical curricula. Our findings suggest that these skills are important and correlate with recognized long-term educational outcomes.
Eisen, O.; Nixdorf, U.; Wilhelms, F.; Steinhage, D.; Miller, H.
Electromagnetic reflection (EMR) measurements are active remote sensing methods that have become a major tool for glaciological investigations. Although the basic pro- cesses are well understood, the unambiguous interpretation of EMR data, especially internal layering, still requires further information. The Antacrtic ice sheet provides a unique setting for investigating the relation between physicalchemical properties of ice and EMR data. Cold ice, smooth surface topography, and low accumulation facilitates matters to use low energy ground penetrating radar (GPR) devices to pene- trate several tens to hundreds of meters of ice, covering several thousands of years of snow deposition history. Thus, sufficient internal layers, primarily of volcanic origin, are recorded to enable studies on a local and regional scale. Based on dated ice core records, GPR measurements at various frequencies, and airborne radio-echo sound- ing (RES) from Dronning Maud Land (DML), Antarctica, combined with numerical modeling techniques, we investigate the influence of internal layering characteristics and properties of the propagating electromagnetic wave on EMR data.
María de los Ángeles AGUILERA VELASCO
Full Text Available A documentary compilation of films about retirement was made. The data of films, in language or subtitles in Spanish, that had an argument related to retirement or that their protagonists evidenced experiences of the retirement were included. The documentary compilation was made through the stages of search and analysis. 54 films were found and organized into nine categories. The oldest film was from 1924 and the most recent of 2017. 61.11% of films were made as of 2010. In five films (9.25% the protagonists wanted to commit suicide when leaving work. Euthanasia (5.55% was performed in three films (5.55%. The problem of retirement in women was found only in four films (7.49%. In 18 films (33.33% the male protagonists went through widowhood. Twenty-one countries participated in productions, the United States produced 21 films (38.88%. It provides a very extensive collection of valuable films that convey great lessons, allow us to reflect and raise awareness of this stage of life. It is recommended to socialize the films through socio-educational interventions and investigations, as well as to begin to inquire scientifically about the relationship between suicide and euthanasia in retirement.
Mike K. MOULTON
Full Text Available This paper outlines a strategy for a faculty development program with respect to net-supported learning. Many universities and colleges are struggling with meeting the demands of a rapidly changing world. Reflections in this paper are based on experiences from the Norwegian University of Life Sciences. Attention has been given to the intelligent use of technology as a means of meeting pressing challenges. What does this mean? I ask a series of questions, the answers of which form the basis for a faculty development program. What qualities and skills should our graduates have? What consequences does this have for the way we approach teaching and learning? And what role does technology play? In short, we must focus on faculty training courses and the ensuing development cycles of trial, error, refinement and sharing. Guiding principles for these activities should be:1. It is about learning.2. It is about easy access.3. It is about emphasizing collaboration.4. It is about support.
Ahmad, I.; Carpenter, M.P.; Emling, H.
Experimental data show that there is no even-even nucleus with a reflection asymmetric shape in its ground state. Maximum octupole- octupole correlations occur in nuclei in the mass 224 (N∼134, Z∼88) region. Parity doublets, which are the characteristic signature of octupole deformation, have been observed in several odd mass Ra, Ac and Pa nuclei. Intertwined negative and positive parity levels have been observed in several even-even Ra and Th nuclei above spin ∼8ℎ. In both cases, the opposite parity states are connected by fast El transitions. In some medium-mass nuclei intertwined negative and positive parity levels have also been observed above spin ∼7ℎ. The nuclei which exhibit octupole deformation in this mass region are 144 Ba, 146 Ba and 146 Ce; 142 Ba, 148 Ce, 150 Ce and 142 Xe do not show these characteristics. No case of parity doublet has been observed in the mass 144 region. 32 refs., 16 figs., 1 tab
Virginia Vargas Valente
Full Text Available Over the course of the past decade, citizenship has become one of the axes of feminist action and reflection in Latin America, and, at the same time, it is at the core of democratic concerns at the national levels and, as never before, at the global level. Citizenship constitutes an important pole in women's long fight for equality, lending new democratic content to feminist debates. It also is a meaningful axis for generating alliances among women and between women and other social groups, with the aim of broadening the limits of citizenship restrained by the manifold discriminations in our societies. Citizenship is a terrain of dispute between civil society and the state, and also within civil society itself. Feminist theorists of citizenship are adding complexity and contributing to a theory of citizenship by pointing to incongruities and weaknesses in the concept and practice of citizenship, recognizing that differences - not only gender-based ones- but among women themselves, may present possibilities and obstacles which need to be enhanced or neutralized.